The Extended Dwell Peripheral Intravenous Catheter Is an Alternative Method of NICU Intravenous Access.
Kimberlee B Chenoweth, Jia-Wen Guo, Belinda Chan
PMID 29847401WHAT IT FOUND
In neonates over 32 weeks and 1500 g, extended dwell peripheral intravenous (EPIV) catheters had fewer severe extravasation injuries than standard peripheral lines.
However, they failed more often than central lines and lasted a shorter time, so they are not a universal replacement.
Key findings
01The rate of significant extravasation requiring hyaluronidase treatment was 1.2% for EPIV catheters compared to 3.9% for standard peripheral intravenous (PIV) catheters.
02EPIV catheters had a lower success rate (71.7%) and shorter mean indwell time (4.0 days) than peripherally inserted central catheters (PICCs), which had an 83.6% success rate and 7.3-day indwell time.
03No life-threatening complications occurred during 1735 EPIV catheter days, whereas PICCs were associated with four life-threatening events including bloodstream infection and cardiac arrhythmia.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was retrospective and conducted at a single center, which limits generalizability. Detailed data on indwell time and success rate for the large PIV catheter group were not available, preventing a full three-way comparison on those metrics. The groups were not randomized; EPIV recipients may have been less ill than PICC recipients, as PICCs are often reserved for more complex needs. Illness severity was not adjusted for as a confounding factor. Cost estimates were based on unit charges and were acknowledged as imprecise.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume EPIV catheters are superior to PICCs for all vascular access needs. While EPIVs had fewer life-threatening complications and lower costs, they had a significantly lower success rate and shorter indwell time than PICCs. PICCs remain the necessary choice for neonates requiring long-term central access or high-osmolarity nutrition.