Ultrasonography-Guided Long Peripheral Catheters: Real-World Outcomes in Hospitalized Children

Area of Science:

• Pediatric vascular access
• Medical device efficacy
• Ultrasound-guided procedures

Background:

• Short peripheral catheters (SPCs) are common but often lead to insertion difficulties and short dwell times in children.
• Limited evidence exists for ultrasonography-guided long peripheral catheters (LPCs) in pediatric wards, especially for 3-6.5 cm lengths.

Purpose of the Study:

• To compare the efficacy and safety of ultrasonography-guided LPCs versus blind-inserted SPCs in pediatric patients.
• To evaluate catheter survival, therapy completion, and complication rates between the two catheter types.

Main Methods:

• Retrospective observational study including pediatric patients (30 days to 18 years) hospitalized for at least 5 days.
• Outcomes assessed: catheter survival time, therapy completion with the first catheter, and complications per 1000 catheter-days.
• Statistical analyses included Kaplan-Meier curves, Cox regression, Poisson regression, and propensity score matching.

Main Results:

• LPCs demonstrated significantly longer median catheter survival (7.0 days vs. 3.0 days) and higher therapy completion rates (56.1% vs. 17.2%) compared to SPCs.
• Complication rates were substantially lower with LPCs (65.5 vs. 193.6 per 1000 catheter-days).
• Adjusted analyses indicated LPCs had a lower risk of failure and were protective against early removal.

Conclusions:

• Ultrasonography-guided LPCs provide superior dwell time, successful therapy completion, and reduced complications in pediatric patients compared to blind-inserted SPCs.
• LPCs should be considered a primary vascular access choice for children needing medium-term therapy, especially those with difficult access or on antibiotics.