Peripheral venous catheter (PVC) vs peripherally inserted central venous catheter (PICC) for very low birth weight newborns. A randomised trial

Abstract

Introduction. Total parenteral nutrition (TPN) is started right after birth for very low birth weight (VLBW) newborns. TPN might be administered via a peripheral venous catheter (PVC) or a peripherally inserted central catheter (PICC). Practices in choosing a catheter vary among different hospitals. A Cochrane review published in 2008 and updated in 2015 found no difference in clinical data and complications when administering TPN via PVC or PICC. METHODS A randomized trial was conducted in the Hospital of the Lithuanian University of Health Sciences Kaunas Clinics. The trial evaluated primary outcomes of VLBW (≥ 750 g - <1,500 g) newborns fed parenterally using PVC or PICC. Patients matching eligibility criteria were randomized into two groups within 24 hours after birth: PVC group and PICC group. The results analyzed and presented here are number of catheters per patient, mean duration of catheter use, mean amounts of administered nutrients and sepsis in both groups. RESULTS A total of 85 newborns were included in the trial: 37 in the PVC group and 48 in the PICC group. The main characteristics of patients were not significantly different (Tab. 1). There were more catheter changes in the PVC group, the duration of one catheter use was longer in the PICC group and the difference was statistically significant (Tab. 2). The rate of total sepsis, sepsis during TPN administration, and age at which sepsis was diagnosed were not statistically significant (Tab. 3).CONCLUSIONS There were significantly fewer catheters used for TPN administration and longer duration of one catheter use in the PICC group. Rate of sepsis was not different in both groups..[...].