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Recurrent peripheral intravenous catheterization in neonates: A case series
Stephanie Hall1,2,3, Emily Larsen1,2,4, Linda Cobbald1
1Women's and Newborns Service, Grantley Stable Neonatal Unit, Nursing and Midwifery Research Centre; Royal Brisbane and Women's Hospital, Herston, Australia.
Nursing in Critical Care
|January 17, 2025
Summary
Extremely low birth weight neonates frequently require multiple peripheral intravenous catheters (PIVCs), often failing before treatment completion. This highlights a need for improved vascular access strategies in neonatal intensive care.
Area of Science:
- Neonatal intensive care
- Vascular access
- Pediatric critical care
Background:
- Neonatal peripheral intravenous catheters (PIVCs) are crucial for treatment but challenging to insert.
- Multiple PIVC insertions cause pain, delay treatment, and increase risks for neonates.
Observation:
- A case series identified 19 neonates (7.6%) requiring ≥3 PIVCs during hospitalization.
- Patients were extremely low birth weight (median 728g) and premature (median 26.6 weeks gestation).
- The hand was the most common insertion site (41.5%), and 57% of PIVCs failed due to complications.
Findings:
- Contrary to perception, extremely low birth weight infants, not larger babies, required frequent cannulation.
- 58% of failed PIVCs necessitated re-insertion, indicating significant treatment interruption.
- Median PIVC dwell time was 49 hours, with many failing well before this.
Implications:
- There is a critical need to investigate decision-making, advanced insertion skills, and alternative vascular access devices.
- Optimizing PIVC selection and insertion techniques can reduce complications and treatment delays in vulnerable neonates.
- This research informs clinical practice to minimize patient injury and improve outcomes in neonatal critical care.
