Peripherally inserted central venous catheter versus peripheral venous catheter. Growth and neurodevelopment of very low birth weight newborn. A randomised trial

Abstract

In very low birth weight (VLBW) newborns, parenteral nutrition (PN) is delivered via a peripheral venous catheter (PVC), a central venous catheter (CVC), or a peripherally inserted central venous catheter (PICC). Up to 45% of PICCs are accompanied by complications, the most common being sepsis. A PVC is an unstable PN delivery technique requiring frequent change. The growth and neurodevelopment of VLBW newborns may be disturbed because of catheters used for early PN delivery and complications thereof. The aim of the conducted study was to evaluate the effect of two PN delivery techniques (PICC and PVC) on anthropometric parameters and neurodevelopment of VLBW newborns. A prospective randomized clinical trial was conducted at the Department of Neonatology of the Hospital of the Lithuanian University of Health Sciences Kauno klinikos between 1 January 2014 and 31 March 2017. Low birth weight (≥750 - <1500 g) newborns that met the inclusion criteria were randomized into two groups: PICC and PVC. For the entire period of treatment, PN was delivered via a catheter chosen during the randomization. In the trial, we assessed short-term outcomes, i.e., anthropometric parameters (weight, length, and head circumference) from birth until CA 36 weeks or upon discharge, and long-term outcomes, i.e., anthropometric parameters (weight, length, and head circumference) from 3 months to CA 12 months as well as neurodevelopment at CA 12 months according to Bayley II. In total, 108 newborns (57 in the PICC group and 51 in the PVC group) underwent randomization. Short-term outcomes were assessed in 47 PICC and 38 PVC subjects. Long-term outcomes were assessed in 38 and 33 subjects of PICC and PVC groups, respectively. There were no differences observed in anthropometric parameters between the subjects of two groups in the short and long term. Delayed mental performance (MDI <85) was observed in 26.3% and 21.2% (p=0.781), and dela[...].