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Comparing conventional and modified Seldinger techniques using a micro-insertion kit for PICC placement in neonates:
Matheus F P T van Rens1,2, Kevin Hugill3, Robin van der Lee1
1Neonatal Intensive Care Unit, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, Netherlands.
Frontiers in Pediatrics
|May 17, 2024
Summary
The modified Seldinger technique (MST) using a micro-insertion kit shows promise for neonatal peripherally inserted central catheter (PICC) placement. This method may reduce complications and catheter-related bloodstream infections (CLABSI) compared to conventional techniques.
Area of Science:
- Neonatal Intensive Care
- Vascular Access Devices
- Medical Device Technology
Background:
- Peripherally inserted central catheters (PICCs) are crucial in neonatal care.
- Conventional insertion methods carry risks of complications and infections.
- Evaluating novel techniques for improved neonatal PICC insertion is essential.
Purpose of the Study:
- To compare the effectiveness of the modified Seldinger technique (MST) with conventional methods for neonatal PICC insertion.
- To assess insertion success rates, complications, and catheter-related infections.
- To evaluate the utility of a dedicated micro-insertion kit for MST.
Main Methods:
- Retrospective observational cohort study over 3 years (2017-2019).
- Analysis of 1,445 neonatal PICC insertion procedures in a tertiary NICU.
- Comparison of MST versus conventional splitting needle/peelable cannula techniques.
Main Results:
- MST showed a trend towards higher first-attempt success rates (91% vs. 88%).
- Conventional techniques had significantly higher rates of catheter-related complications (p < 0.001).
- MST group had significantly fewer catheter-related bloodstream infections (CLABSI) (1.06/1,000 catheter days vs. 3.45/1,000 catheter days; p < 0.001).
Conclusions:
- MST with a micro-insertion kit is a viable option for neonatal PICC insertion.
- This technique is associated with improved success rates and reduced complications, including CLABSI.
- Further prospective multicenter studies are recommended to confirm these findings.
