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Published on: December 23, 2014
Ultrasound-Guided Non-Tunneled Centrally Inserted Central Catheters versus Peripherally Inserted Central Catheters in
Antonella Capasso1, Fiorentino Grasso2, Mario Meliande1
1Neonatology and Neonatal Intensive Care Unit, Department of Translational Medicine, University of Naples Federico II, Naples, Italy.
Introduction:
Peripherally inserted central catheters (n-PICCs) are standard in neonatal intensive care but carry high complication rates. Ultrasound-guided non-tunneled centrally inserted central catheters (nT-CICCs) offer a potential alternative. This study compared outcomes of nT-CICCs versus n-PICCs in extremely low birth weight (ELBW) neonates.
Methods:
This is a single-center, comparative cohort study (April 2022-October 2025) enrolling neonates <1,000 g requiring central venous access. A retrospective cohort receiving n-PICCs was compared with a prospective cohort receiving nT-CICCs. The primary outcome was central line-associated bloodstream infection (CLABSI) density rate on successfully placed catheters. Secondary outcomes included procedural success, mechanical complications, and risk factors for CLABSI.
Results:
We analyzed 103 catheter insertions (50 nT-CICCs, 53 n-PICCs). Procedural success was 100% for nT-CICCs and 94% for n-PICCs (3 immediate failures excluded from follow-up). Among 100 indwelling catheters, nT-CICCs showed significantly lower CLABSI rates (1.83 vs. 11.09 per 1,000 catheter-days; p = 0.038). Overall complications affected 4% of the nT-CICC group versus 64% of the n-PICC group (p < 0.001). nT-CICCs enabled therapy completion in 66% of cases compared with 12% for n-PICCs. Catheter type was the sole independent predictor of CLABSI (adjusted HR 7.1, 95% CI: 1.01-49.74; p = 0.048).
Conclusions:
Ultrasound-guided nT-CICCs are associated with significantly lower rates of infectious and mechanical complications compared with n-PICCs in ELBW neonates. This approach provides a safer and more durable option for central venous access in this vulnerable population.
