Comparative study of peripheral intravenous cannulae versus peripherally inserted central venous catheters in newborn infants

ABSTRACT

Newborn infants especially the high-risk groups require venous access for total or partial parenteral nutrition, intravenous fluids and medications for prolonged periods of time. The aim of this study was to compare between the complications of peripheral intravenous cannulae [nosocomial infection, local complications and mechanical complications] versus peripherally inserted centrally placed catheters in neonates. The present study was carried out on 50 neonates admitted to the Neonatal Intensive Care Unit [NICU] of Minoufiya University Hospital from June 2002 to June 2003 and expected to require venous access for at least 7 days for intravenous [IV] fluids, IV antibiotics, IV medications or parenteral nutrition. All infants were assigned randomly on admission to use either peripheral intravenous [PIV] cannula [n=25] referred to as [PIV group] or peripherally inserted central [PICC] catheters [n=25] referred to as [PICC group]. We found that there was a significant difference between both groups as regard number of attempts of insertion required for total IV therapy [2.36 +/- 1.07 in PICC group versus 11.48 +/- 5.72 in PIV group P<0.001]. The mean number of catheters used was significantly lower with PICC group than PIV group [1.08 +/- 0.27 in PICC group versus 6.52 +/- 3.77 in PIV group P<0.001]. Episodes of proven sepsis in PICC group were found to be significantly lower than in PIV group [5 cases [20%] in PICC group versus 12 cases [48%] in P/V group P<0.05]. The average time to develop sepsis [infection free catheter days] in PICC group was significantly higher than that in Ply group [5.67 +/- 3.13 in PICC group versus 2.83 +/- 1.03 in PIV group P<0.001]. The mechanical complication was statistically significantly lower in the PICC group than that in the PIV group. The rates of phlebitis and catheter associated infection are lower in the PICC group than the PIV group. Apart from the high cost, PICC is a desirable intravascular device in newborn with difficult venous access and in those requiring prolonged antibiotics or fluid therapy