Use of 8-cm 22G-long peripheral cannulas in pediatric patients

Pacilli, Maurizio; Bradshaw, Catherine J.; Clarke, Simon A.

doi:10.1177/1129729818761278

Cited by 14 publications

(47 citation statements)

References 19 publications

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“…For hospitalized children and adolescents, PIVCs and midline catheters were reported as appropriate for short-term peripherally compatible therapies in multiple studies because of their low risk of catheter-related infections and thrombosis in comparison to PICCs. 14,43,94,100,127,143 However, in one study, the authors suggested that these devices are associated with increased risk of occlusion with extended dwell times. 127 PICCs were reported to have high insertion success rates 84 and low failure rates in children and adolescents, 6,59 although one study reported severe complications in 40.1% of failed PICCs, associated with increasing patient age.…”

Section: Figurementioning

confidence: 99%

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

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OBJECTIVE: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). DATA SOURCES: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. STUDY SELECTION: Clinical practice guidelines, systematic reviews, cohort designs, randomized control trials (RCTs), quasi RCTs, before-after trials, or case-control studies that reported on complications and/or risk as well as reliability of VADs in patients aged 0 to 18 years were included. DATA EXTRACTION: Articles were independently reviewed to extract and summarize details on the number of patients and catheters, population, age of participants, VAD type, study method, indication, comparators, and the frequency of VAD failure or complications. RESULTS: VAD selection and insertion decision-making in general hospitalized and some specialized patient populations were well evidenced. The use of single-lumen devices and ultrasound-guided techniques was also broadly supported. There was a lack of RCTs, and for neonates, cardiac patients, patients with difficult venous access, midline catheters, catheter-tovein ratio, and near-infrared devices, the lack of evidence necessitated broadening the review scope. LIMITATIONS: Limitations include the lack of formal assessment of the quality of evidence and the lack of RCTs and systematic reviews. Consequently, clinical decision-making in certain pediatric populations is not guided by strong, evidence-based recommendations. CONCLUSIONS: This is the first synthesis of available evidence for the selection and insertion of VADs in pediatric patients and is important for determining the appropriateness of VADs in pediatric patients. WHAT'S KNOWN ON THIS SUBJECT: Individual studies, systematic reviews, and focused clinical practice guidelines that evaluate vascular access devices (VADs) in various pediatric populations are available. However, to date, no systematic review examining the appropriateness, and inappropriateness, of VADs across common pediatric clinical scenarios exists. WHAT THIS STUDY ADDS: There is strong evidence to support and facilitate appropriate clinical decision-making in some pediatric indications. However, certain populations, device types and characteristics, and insertion procedures are poorly evidenced, necessitating the application of clinical judgment for VAD decision-making.

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Section: Figurementioning

confidence: 99%

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

et al. 2020

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“…Although currently underutilised, this seems promising access for children undergoing surgery, where a single venous cannula can suffice the duration of care. [21]…”

Section: Types Of Vascular Accessmentioning

confidence: 99%

Vascular access in children

2019

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Securing stable vascular access is an important clinical skill for the anaesthesiologist. Sick children, complex surgeries, chronic illnesses, multiple hospitalisations, and prolonged treatments can make vascular access challenging. A search was done in the English language literature using the keywords “paediatric,” “vascular access,” “venous access,” and “techniques” or “complications” in Pubmed, Embase, and Google scholar databases. Articles were screened and appropriate content was included. Intraosseous access is a lifesaving technique that can be performed even in hypovolaemic patients rapidly. Transillumination and near-infrared light improve visualisation of superficial veins in difficult access. Ultrasonography has become the standard of care in selecting the vessel, size of catheter, guide placement, and prevent complications. Fluoroscopy is used during insertion of long-term vascular access devices. This article reviews the various routes of access, their indications, most appropriate site, securing techniques, advantages, disadvantages, and complications associated with vascular access in children.

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“…LPCs are less durable than MCs and, thus, may only remain in situ for 4 weeks. 7 An important difference between MCs and LPCs is their method of insertion. [8][9][10] LPCs are inserted with a simple catheter-over-needle technique or a direct Seldinger technique (originally developed for arterial catheterisation).…”

mentioning

confidence: 99%

“…Among which, we identified over a dozen different labels. These include '15 cm catheter', 12 'catheter inserted with a Seldinger method', 13 'extended dwell/midline peripheral catheter', 14 'Leaderflex line', 15 'long catheter', [16][17][18] 'long IV catheter', 18 'long peripheral cannula', 7,9 'long peripheral catheter', 10 'long peripheral venous catheter', 8 'long polyurethane catheter', 10 'midline cannula', 16 'mini-midline', 19 'peripheral intravenous catheter', 20 'Seldinger catheter', 18 'short midline catheter', 10 'short long line', 15 and 'ultrasound-guided peripheral intravenous catheter'. 1,13 Further details are presented in Table 2.…”

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confidence: 99%

“…However, on closer inspection, each of the studies uses identical 8 cm 22G Leaderflex catheters (Vygon, UK). Carroll et al 15 termed the LPC a ‘Leaderflex line’, while Qian et al 18 and Pacilli et al 7 labelled it a ‘Seldinger catheter’ and ‘long peripheral cannula’, respectively. The International Journal of Emergency Medicine published a fourth study examining the Leaderflex catheter where it was named a ‘short midline’.…”

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confidence: 99%

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Long peripheral catheters: Is it time to address the confusion?

2018

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Long peripheral catheters are 6–15 cm peripheral dwelling catheters that are inserted via a catheter-over-needle or direct Seldinger (catheter-over-guidewire) technique. When inserted in the upper extremity, the distal tip terminates before reaching the axilla, typically no further than the mid-upper arm. This is distinct from a midline catheter, which is inserted via a modified Seldinger technique and terminates at the axilla. The nomenclature of this catheter is confusing and inconsistent. We have identified over a dozen labels in the literature, all describing the same device. These include ‘15 cm catheter’, ‘catheter inserted with a Seldinger method’, ‘extended dwell/midline peripheral catheter’, ‘Leaderflex line’, ‘long catheter’, ‘long IV catheter’, ‘long peripheral cannula’, ‘long peripheral catheter’, ‘long peripheral venous catheter’, ‘long polyurethane catheter’, ‘midline cannula’, ‘mini-midline’, ‘peripheral intravenous catheter’, ‘Seldinger catheter’, ‘short midline catheter’, ‘short long line’ and ‘ultrasound-guided peripheral intravenous catheter’. The purpose of this editorial is to achieve some level of standardisation in the nomenclature of this device. Is it time to address the confusion? We suggest adopting ‘long peripheral catheter’. However, we encourage discussion and debate in reaching a consensus.

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Use of 8-cm 22G-long peripheral cannulas in pediatric patients

Abstract: Long peripheral cannulas represent a valid option for medium-term intravenous access in children undergoing surgery. Majority of patients will be successfully treated with one long peripheral cannula for the duration of their treatment without the need for further cannulation.

Cited by 14 publications

References 19 publications

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review

Vascular access in children

Long peripheral catheters: Is it time to address the confusion?

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