Introduction: Non-critically ill neonates at times require venous access to provide peripherally compatible infusions for a limited period (more than 3 days). In such a situation, short peripheral cannulas are not appropriate as their average duration is about 2 days, while—on the other hand—epicutaneous-caval catheters may be too invasive. In these patients, insertion of long peripheral cannulas may be an effective option. Methods: In this observational retrospective study, we revised all “long” peripheral catheters (4 and 6 cm long) inserted by direct Seldinger technique in our neonatal intensive care unit when peripheral venous access was required for more than 3 days. Results: We inserted 52 2Fr polyurethane catheters, either 4 cm long ( n = 25) or 6 cm long ( n = 27) in 52 patients. Mean dwelling time was 4.17 days (range 1–12). Most devices were inserted in the cephalic vein ( n = 18, 35%), and the rest in the saphenous vein ( n = 11, 21%) and other superficial veins. There was no significant correlation between the duration of the device and type of infusion ( p = 0.40). The main complications were infiltration ( n = 16, 31%) and phlebitis ( n = 8, 15%). The rate of removal due to complications was significantly higher ( p < 0.01) in neonates with bodyweight <2000 g at the time of insertion. Conclusion: In our experience, 2 Fr 4–6 cm long peripheral catheters may be a valid option for neonates requiring peripherally compatible infusions for more than 3 days. The limits of this study are the necessity of training in the technique of insertion and the small size of our sample. The longest dwell was observed in neonates weighing >2000 g at the time of LPC insertion.
We report the clinical cases of three neonates, all of them premature, requiring the placement of a chest tube for drainage of a massive pleural effusion. In all three patients, the chest tube was secured using a new subcutaneously anchored sutureless system. This new securement device was easy to insert and to remove, and highly effective in preventing dislodgment. Also, it was not associated to any undesired effect: no sign of pain and/or discomfort and no skin inflammation. The securement device proved to be comfortable and harmless even in fragile patients as neonates, including the frailest ones, the premature. To our best knowledge, this is the first report describing the use of such a device for this purpose.
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