Evaluation of vascular accesses in the neonatal intensive care unit. Is the midline catheter a useful long-term alternative?

Abstract

Objective: Analyze the usefulness of the midline catheter in terms of efficacy and safety for treatments lasting more than 3 days in the neonatal population requiring admission to the NICU.

Design: Analytical and observational of a prospective cohort (December 2021-November 2023) compared to a historical cohort (January 2020-November 2021).

Setting: 9-bed Neonatal Intensive Care Unit (NICU, level III hospital.

Patients or participants: 288, 66 midline group and 222 control group.

Inclusion criteria: newborns from 24 to 42 weeks of gestation who required short peripheral or midline cannulation and treatment longer than 3 days.

Interventions: Follow-up during NICU stay and comparison with retrospective data from a historical cohort.

Main variables of interest: Sociodemographics, success rate (permanence of the same vascular catheter without complications until finish the prescribed treatment), number of catheters, cannulation rate per patient, indwell time, complications.

Results: The midline group showed a higher success rate (54.2% vs 5.6%, p < 0.001), a lower number of canalizations per patient (p < 0.001), a longer indwell time (p < 0.001) and a lower number of extravasations (p < 0.001).

Conclusions: The midline catheter has advantages over short peripheral catheters, being a useful alternative in terms of efficacy and safety for treatments lasting more than 3 days in the neonatal population that requires admission to the NICU.

Keywords: Accesos venosos; Catéter midline; Catéteres periféricos cortos; Línea media; Midline; Midline catheter; Neonates; Neonatos; Short peripheral catheters; Venous accesses.