Short Peripheral Catheters in Neonates: Procedural Burden and Predictors of Complications - A Prospective Cohort Study.

INTRODUCTION: Short peripheral catheters (SPCs) are the most frequently used vascular access devices in neonatal care. However, prospective data quantifying the procedural burden of SPC use and identifying predictors of complications in term and preterm infants remain limited. METHODS: In this prospective cohort study, 170 neonates undergoing SPC insertion during the first 7 days of life were included. A total of 354 cannulation procedures were recorded. The primary outcome was the occurrence of at least one SPC-related complication. Procedural burden was assessed using descriptive and exposure-adjusted analyses, and predictors of complications were evaluated using multivariable logistic regression. RESULTS: First-attempt success was achieved in only 30.6% of infants, and the median number of attempts required per patient was 3 (range 1 - 23). At least one complication occurred in 66.5% of neonates. In multivariable analysis , day of life at first cannulation, more than one insertion attempt, and parenteral nutrition were independently associated with complications. CONCLUSION: SPC use in neonates was associated with substantial procedural burden and frequent complications. Importantly, this burden was not confined to the most immature infants, but was also pronounced in moderate and late preterm neonates. These findings suggest that a routine peripheral-first strategy may not always be appropriate in this group and support earlier consideration of alternative vascular access strategies.