Short versus long peripheral intravenous catheters in neonates: a retrospective cohort study

Neonatal-short peripheral intravenous catheters (n-SPCs) and neonatal-long peripheral intravenous catheters (n-LPCs) are widely used for short-term vascular access in neonates. A retrospective single-centred cohort study was conducted in the neonatal intensive care unit between 2019 and 2022 to compare the 2 types of catheters. A total of 34,464 catheter insertions were analysed (32,885 n-SPCs, 1,579 n-LPCs). n-LPCs had longer dwell time (48:27 ± 39:08 h versus 34:01 ± 33:31 h, p < 0.001). Accidental removals were lower in n-LPCs (0.3% versus 2.6%, p < 0.001). n-LPCs had higher rates of phlebitis (16.1% versus 6.6%, p < 0.001) and peripheral intravenous infiltration or extravasation (PIVIE) rate (40.0% versus 29.9%). Severe PIVIE (≥ 30% severity) was higher in n-LPCs (8.5% versus 2.8%, p < 0.001). n-LPCs offer a more stable and effective option for peripheral vascular access in neonates. Their use should be balanced with strategies to reduce the risk of phlebitis and severe PIVIE.