Umbilical and Peripheral Venous Catheter-Related Outcomes in Premature Neonates

TL;DR

Umbilical venous catheters are faster and safer than PICCs for preterm infants in the early postnatal period.

Contribution

The study provides a direct comparison of UVC and PICC outcomes in preterm infants, highlighting UVC as a superior initial option.

Findings

UVC insertion was faster and required fewer attempts and operators than PICC.

PICC had higher rates of thrombosis and leakage compared to UVC.

Infection rates were similar, but PICC had higher mechanical complications.

Abstract

What are the main findings?

Umbilical venous catheter (UVC) insertion was faster, required fewer attempts, and was associated with fewer thrombosis and leakage complications compared with peripherally inserted central catheters (PICCs).Infection rates were similar between UVC and PICC, but PICC use carried higher risks of mechanical complications and the need for additional vascular access.

Umbilical venous catheter (UVC) insertion was faster, required fewer attempts, and was associated with fewer thrombosis and leakage complications compared with peripherally inserted central catheters (PICCs).

Infection rates were similar between UVC and PICC, but PICC use carried higher risks of mechanical complications and the need for additional vascular access.

What are the implications of the main findings?

UVC should be considered the preferred first-line venous access in preterm infants during the early postnatal period.PICC may be a better option after UVC removal when ongoing long-term vascular access is required.

UVC should be considered the preferred first-line venous access in preterm infants during the early postnatal period.

PICC may be a better option after UVC removal when ongoing long-term vascular access is required.

Background: Central venous catheters are essential but associated with complications in premature infants. We compared the short-term outcomes of umbilical venous catheter (UVC) versus peripherally inserted central catheter (PICC) as the initial postnatal primary venous access in preterm infants. Methods: Preterm infants with a birth weight ≤ 1500 g within the first postnatal hours were included. Patients were randomly assigned to the UVC or PICC groups. Catheter insertion time, number of attempts, number of operators, duration of catheter use, reason for removal, and overall duration were recorded. Results: A total of 107 premature infants were included, with 63 receiving UVC and 44 receiving PICC. Nineteen infants who initially had UVC placement on day 1 required PICC placement on day 5. The number of attempts, number of operators, and insertion time were significantly higher in the PICC group compared with the UVC group (p < 0.001, p = 0.002, and p = 0.002, respectively). Catheter removal due to thrombosis or leakage occurred in 14.2% of UVC cases versus 40.1% of PICC cases (p = 0.002). Conclusion: UVC placement appears to be superior to PICC as the first venous access in preterm infants during the early postnatal period. PICC placement may be less advantageous in the first days of life due to a smaller catheter diameter, technical difficulty, and longer insertion time.

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