Recurrent Peripheral Intravenous Catheterization in Neonates: A Case Series

Neonates requiring multiple peripheral intravenous catheter (PIVC) insertions face high failure rates and increased discomfort. A recent study examined 19 neonates in an Australian NICU, revealing key challenges in neonatal vascular access.

Key Findings
Low birth weight neonates (median 728g) needed frequent PIVC insertions.
57% of PIVCs failed, mainly due to infiltration, occlusion, and dislodgement.
Median dwell time: 49 hours, with 58% of failed catheters requiring reinsertion.
Hand (41.5%) was the most common insertion site.

Implications for Care

• Better device selection (e.g., central lines) for high-risk neonates.
• Advanced training to improve first-time insertion success.
• Securement strategies to extend catheter lifespan and reduce failure rates.

Conclusion
Neonatal PIVC failure remains a critical issue, requiring better decision-making, insertion techniques, and alternative vascular access approaches to enhance patient outcomes.

Authors: Stephanie Hall, Emily Larsen, Linda Cobbald, Nicole Marsh, Linda McLaughlin, Mari Takashima, Robert S. Ware, Amanda Ullman, Deanne August