Percutaneous central venous catheterization: five year experiment in a neonatal intensive care unit

We evaluated the clinical application of percutaneous central venous catheter (PCVC) in our neonatal intensive care unit (NICU). During a five-year study, 610 PCVCs were placed in 496 infants for a total of 10,243 days. The success catheterization rate was 92%. Among them, 82.7% needed only one PCVC. The body weight of babies ranged from 460 g to 5,340 g. Of 610 PCVCs, 337 (45.2%) were placed in infants weighing 1,500 g or less. About half (50.7%) of the PCVCs were placed within the first 24 hours of life. Common sites for insertion were the dorsal aspect of hands (48.8%) and the antecubital region (25.1%). Mean PCVC stay was 17.6 days (range, less than 1 to 74 days). The duration was longer (18.5 days) in infants weighing 1,500 g or less. Almost four fifth (79.2%) of 586 PCVCs were removed electively and one tenth was due to either mechanical problems (10.7%) or suspected catheter-related infection (10.1%). Of 586 PCVCs, catheter-related sepsis was confirmed in 3.4% (20/586), or 2.1 per 1,000 catheter-days. No immediate complication was attributed to the insertion procedure. We conclude that PCVC is a safe and effective technique for prolonged intravenous therapy in NICU.