Randomized comparative trial between percutaneous longlines and peripheralcannulae in the delivery of neonatal parenteral nutrition

Percutaneously inserted central venous catheters (CVCs) are frequently used for parenteral nutrition (PN) in neonates. Catheter-related sepsis (CRS) i s the most commonly reported complication. The aim of this study was to com pare sepsis rates between neonates receiving PN by CVC and by peripheral ca nnula. Neonates were randomized to receive PN either by CVC or by periphera l cannula. Primary outcomes were sepsis rates and efficacy or PN delivery. Interim analysis (49 neonates) revealed no difference in sepsis rates (CVC group 46%, cannula group 40%, p = 0.57). There was a significant discrepanc y in PN delivered (median deficit 3.2% in the CVC group, 10.3% in the cannu la group, p = 0.0014). After consideration of these findings the study was terminated. Conclusion: Because the trial was stopped early, small but clinically impor tant differences in the rates of sepsis may have been missed. Neonates in t he cannula group accrued significant deficits of PN owing to a lack of veno us access. This may contribute to undernutrition in neonates. CVC can be ad vocated for PN administration, in that sepsis appears to be no higher than when using cannulae and delivery of nutrition is significantly better.