Central-venous access through the peripheral route in surgical neonates: an audit of 125 consecutive lines from a regional neonatal centre

A long Percutaneous silastic IV line is frequently used in surgical neonate s for infusion of hyperosmolar parenteral nutrition fluid into a central ve in for several days without the need for operative insertion of a Broviac c atheter or risks of direct puncture of a central vein. Our study was aimed at auditing the performance of 125 consecutive lines over a 2-year period. During this period, insertion was attempted in 125 babies; in 13 cases the line could not be inserted because of technical problems. The gestational a ges varied between 25 and 41 weeks and weights between 630 g and 4.2 kg. Su ccess did not appear to be related to the age or weight of the baby. The me an duration of complication-free performance was 22.4 days. There was a sig nificant difference between the complication rate of lines inserted in the operating theatre versus those on the ward (P < 0.05). There was no signifi cant increase in complications in lines used for over 4 weeks. The techniqu e adopted by us for inserting these lines is likely to succeed in the major ity of cases, including premature and small-for-dates babies. In our experi ence, lines inserted in the controlled theatre environment either before or after abdominal surgery performed better. The manufacturer's recommendatio n to electively change the line every 4 weeks needs further prospective eva luation.