Epicutaneo-caval catheters in neonates: New insights and new suggestions from the recent literature

Barone, Giuseppe; Pittiruti, Mauro

doi:10.1177/1129729819891546

Cited by 48 publications

(69 citation statements)

References 46 publications

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“…In these situations, the placement of a large bore polyurethane catheter (3)(4) in the brachiocephalic vein (BCV; centrally inserted central catheters (CICC)) can be more appropriate. [2][3][4][5][6] The aim of this study is to describe our experience with CICC insertion in preterm neonates with a weight below 1500 g.…”

Section: Introductionmentioning

confidence: 99%

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

et al. 2020

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Objective: Central venous access in critically ill newborns can be challenging. Ultrasound-guided brachio-cephalic vein catheterization is a relatively new procedure, recently introduced in several neonatal intensive care units. The aim of this study is to evaluate the safety and feasibility of such a technique in preterm babies. Design: Retrospective analysis of prospectively collected data on ultrasound-guided central venous catheter insertion in preterm neonates. Setting: Neonatal intensive care unit. Patients: Critically ill preterm neonates with weight below 1500 g requiring a central access. Interventions: Ultrasound-guided brachio-cephalic vein catheterization. Main Results: Thirty centrally inserted catheters were placed in 30 neonates. The success rate of the procedure was 100%. No case of accidental arterial or pleural puncture was registered during the study period. Conclusion: The brachio-cephalic vein can be safely catheterized in preterm newborns requiring intensive care after appropriate training.

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Section: Introductionmentioning

confidence: 99%

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

et al. 2020

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“…In their study, the eligible patients were "children aged 6 months to less than 18 years with a newly placed PICC or tunneled lines (TL). [8][9][10] In other words, ECC in neonates/ infants and PICC in children are two devices that should never be pooled together in the same analysis.…”

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confidence: 99%

In defense of the use of peripherally inserted central catheters in pediatric patients

et al. 2020

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Central venous access devices have revolutioned the care of children affected by malignancies, facilitating management of complex and prolonged infusive therapies, reducing pain and discomfort related to repeated blood samples and indiscriminate venipunctures, thus reducing also psychological stress of both patients and families. In this respect, peripherally inserted central catheters have been disseminated for use, even in pediatric oncology patients, for their many advantages: easy and non-invasive placement with no risk of insertion-related complications, as well as easy removal; reduced need for general anesthesia both for insertion and removal; adequate prolonged performance also for challenging therapies (e.g. stem cell transplantation); and low rate of late complications. Nonetheless, concerns have been recently raised about use of such devices in children with cancer, especially regarding a presumed (but not demonstrated) high risk of catheter-related venous thrombosis. Are we facing a new witch (or peripherally inserted central catheter) hunt? The choice of the central venous access device—particularly in oncologic children—should be based on an evaluation of clinical advantages and risks, as provided by appropriate and scientifically accurate clinical studies.

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“…Further large studies are recommended to come up with a conclusion regarding its feasibility in neonates. 5 , 33 – 36 …”

Section: Discussionmentioning

confidence: 99%

“…Compared to PIVCs, they decrease the number of painful procedures and needle sticks, without significantly increasing the rate of sepsis. 1 – 5 Like other vascular access devices (VADs), ECCs are associated with various complications such as occlusion, infection, thrombosis, breakage, migration, and displacement, which lead to non-selective removal of the catheter. However, ECCs are a safe choice to deliver intravenous (IV) therapy.…”

Section: Introductionmentioning

confidence: 99%

Effect of implementing an Epicutaneo-Caval Catheter team in Neonatal Intensive Care Unit

et al. 2020

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Background: Until the 1980s, central vascular access in the Neonatal Intensive Care Unit was predominantly delivered by umbilical catheters and only and if needed by surgical cutdowns or subclavian vein catheterization through blind percutaneous venipuncture. In the early 1980s, epicutaneo-caval catheters were successfully introduced. Methods: In our Neonatal Intensive Care Unit, a dedicated team to insert epicutaneo-caval catheters was formally established in January 2017, including 12 neonatologists and 1 neonatal nurse practitioner. A before- versus after-intervention study was designed to determine whether the establishment of the epicutaneo-caval catheter insertion team is associated with increased success rates and a decreased risk of catheter-related complications. Success rates and other catheter-related parameters were traced from 2016 onward. Collected data were analyzed for three consecutive years: 2016, 2017, and 2018. Results: The epicutaneo-caval catheter team inserted 1336 catheters over 3 years. Both first prick (from 57.7% to 66.9%; p = 0.023) and overall success (from 81.7% to 97.6%; p < 0.0001) rates significantly improved. In 2018, the number of tunneled or surgically inserted central venous catheters came down to zero (p < 0.0001). Overall catheter-related complications were significantly lower following the epicutaneo-caval catheter team’s establishment (p < 0.0001) while there was no significant decrease noted (p = 0.978) in central line–associated bacterial stream infection rates. Conclusion: A dedicated epicutaneo-caval catheter team is a promising intervention to increase success rates and significantly decrease catheter-related complications in Neonatal Intensive Care Unit. Standardizing epicutaneo-caval catheter placement is important; however, standardizing catheter maintenance seems essential to the improvement of central line–associated bacterial stream infection rates.

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Epicutaneo-caval catheters in neonates: New insights and new suggestions from the recent literature

Cited by 48 publications

References 46 publications

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein

In defense of the use of peripherally inserted central catheters in pediatric patients

Effect of implementing an Epicutaneo-Caval Catheter team in Neonatal Intensive Care Unit

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