Analysis of Influencing Factors of Medium-Length Catheter-Related Complications in Neonates in Neonatal Intensive Care Unit

A medium-length catheter is a peripheral venous infusion device inserted through peripheral vein puncture, with the catheter tip reaching the axillary vein or subclavian vein, and can be indwelled for 1-4 weeks. The commonly used veins in children and adults are the median cubital vein, basilic vein, brachial vein, and cephalic vein. For neonates and infants, in addition to elbow veins, it can also be inserted through scalp veins with the catheter tip located in the jugular vein above the clavicle, or inserted through lower extremity veins with the tip located below the inguinal crease. For neonates requiring long-term infusion, the application of peripheral venous indwelling needles will increase the number of punctures and the pain of neonates. However, medium-length catheters have the characteristics of long indwelling time, convenient operation, and no need for X-ray radiography, which meet the needs of neonates with long infusion time and difficult venous puncture.

At present, studies on the influencing factors of medium-length catheter complications are mostly reported in adults. This study collected medical records of 178 neonates with gestational age of 29-41 weeks and birth weight of 1680-4200 g who were treated with 2Fr medium-length catheters from February 2021 to June 2022, to investigate the occurrence of medium-length catheter-related complications in neonates and analyze its influencing factors, so as to provide reference for the application of medium-length catheters in clinical NICU neonates.

Table 1 Univariate analysis of MC complications in NICU neonates [n; percentage (%)]

Table 3 Multivariate logistic regression analysis of complications after neonatal MC catheterization

Puncture site: Puncture at median cubital vein, basilic vein, cephalic vein, and superficial temporal vein

Catheter tip position: Thoracic segment of axillary vein, subclavian vein, or jugular vein

Complications: 33 cases, including extravasation, slippage, and phlebitis

Univariate analysis of complications after neonatal medium-length catheterization: Birth weight, selection of puncture vein, catheter tip position, indwelling time, and presence or absence of internal fixation were related to the occurrence of complications of neonatal medium-length catheters. The lighter the weight, the more likely phlebitis is to occur. The incidence of complications when the catheter tip is placed in the axillary vein or jugular vein is higher than that in the subclavian vein, with the jugular vein being the most obvious.

Multivariate analysis of complications after neonatal medium-length catheterization: The complication rate of catheterization via superficial temporal vein is higher than that via median cubital vein or basilic vein

In conclusion, during the application of MC in neonates, selecting basilic vein or median cubital vein for puncture, placing the catheter tip in the subclavian vein or thoracic segment of axillary vein, and choosing internal fixation can reduce the incidence of neonatal MC complications.

References:

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[4] TAO Y J, YANG L J, DAI M H, et al. Analysis of influencing factors of medium-length catheter-related complications in neonates in neonatal intensive care unit[J]. Journal of Bengbu Medical College, 2024, 49(10): 1407-1411. DOI: 10.13898/j.cnki.issn.1000-2200.2024.10.029.