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Devices for Neonatal Peripheral Catheterization and Tip Confirmation : A Systematic Review and Meta-Analysis

Shcherbatiuk, Kristina ; Magagnoli, Clelia ; Susca, Francesco ; Caratozzolo, Daniele ; Fiander, Michelle ; Soll, Roger Franklin ; Bruschettini, Matteo LU orcid and Romantsik, Olga LU (2025) In Neonatology p.1-17
Abstract

Abstract – Introduction: Peripheral intravenous catheterization is commonly required in sick neonates but remains challenging due to small vessels, leading to multiple attempts and complications. This review evaluated the benefits and harms of device-assisted techniques versus standard technique. Methods: We searched MEDLINE, Embase, CENTRAL, Cochrane Reviews, WHO ICTRP, and ClinicalTrials.gov (October 2024) for randomized controlled trials (RCTs). Data collection and analysis followed Cochrane methodology. Results: We included 12 RCTs (1, 251 neonates). Devices were used for placement in 5 studies (417 neonates) and tip confirmation in 6 studies (740 neonates). One study used ultrasound for both PICC placement and tip confirmation (94... (More)

Abstract – Introduction: Peripheral intravenous catheterization is commonly required in sick neonates but remains challenging due to small vessels, leading to multiple attempts and complications. This review evaluated the benefits and harms of device-assisted techniques versus standard technique. Methods: We searched MEDLINE, Embase, CENTRAL, Cochrane Reviews, WHO ICTRP, and ClinicalTrials.gov (October 2024) for randomized controlled trials (RCTs). Data collection and analysis followed Cochrane methodology. Results: We included 12 RCTs (1, 251 neonates). Devices were used for placement in 5 studies (417 neonates) and tip confirmation in 6 studies (740 neonates). One study used ultrasound for both PICC placement and tip confirmation (94 neonates). Devices may increase first-attempt success compared to standard technique: risk ratio (RR): 1.18, 95% confidence interval (CI): 1.04–1.33 for placement and RR: 1.20, 95% CI: 1.10–1.30 for tip confirmation. Six studies (528 neonates) reported a shorter time to successful catheterization. Devices likely reduce hematoma (RR: 0.32, 95% CI: 0.13–0.75), bleeding (MD: −0.68, 95% CI: −0.83 to −0.53), and phlebitis (RR: 0.19, 95% CI: 0.06–0.58). Evidence was of very low certainty for thrombosis for placement (RR: 0.33, 95% CI: 0.01–7.99) and tip confirmation (RR: 0.25, 95% CI: 0.05–1.16), catheter-related bloodstream infection (RR: 1.25, 95% CI: 0.34–4.58), and arrhythmia (RR: 0.09, 95% CI: 0.01–0.70). Conclusion: Device-assisted catheterization may improve first-attempt success and reduce procedure time in neonates. Evidence on safety is limited. Due to variability in study methodologies and outcome reporting, high-quality RCTs with standardized outcome measures are needed.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Catheterization, Devices, Neonates, Success, Systematic review
in
Neonatology
pages
17 pages
publisher
Karger
external identifiers
  • scopus:105027441751
  • pmid:41171990
ISSN
1661-7800
DOI
10.1159/000549323
language
English
LU publication?
yes
id
2f595736-2d23-444b-b500-40a7e24da101
date added to LUP
2026-02-13 14:36:33
date last changed
2026-02-14 03:25:28
@article{2f595736-2d23-444b-b500-40a7e24da101,
  abstract     = {{<p>Abstract – Introduction: Peripheral intravenous catheterization is commonly required in sick neonates but remains challenging due to small vessels, leading to multiple attempts and complications. This review evaluated the benefits and harms of device-assisted techniques versus standard technique. Methods: We searched MEDLINE, Embase, CENTRAL, Cochrane Reviews, WHO ICTRP, and ClinicalTrials.gov (October 2024) for randomized controlled trials (RCTs). Data collection and analysis followed Cochrane methodology. Results: We included 12 RCTs (1, 251 neonates). Devices were used for placement in 5 studies (417 neonates) and tip confirmation in 6 studies (740 neonates). One study used ultrasound for both PICC placement and tip confirmation (94 neonates). Devices may increase first-attempt success compared to standard technique: risk ratio (RR): 1.18, 95% confidence interval (CI): 1.04–1.33 for placement and RR: 1.20, 95% CI: 1.10–1.30 for tip confirmation. Six studies (528 neonates) reported a shorter time to successful catheterization. Devices likely reduce hematoma (RR: 0.32, 95% CI: 0.13–0.75), bleeding (MD: −0.68, 95% CI: −0.83 to −0.53), and phlebitis (RR: 0.19, 95% CI: 0.06–0.58). Evidence was of very low certainty for thrombosis for placement (RR: 0.33, 95% CI: 0.01–7.99) and tip confirmation (RR: 0.25, 95% CI: 0.05–1.16), catheter-related bloodstream infection (RR: 1.25, 95% CI: 0.34–4.58), and arrhythmia (RR: 0.09, 95% CI: 0.01–0.70). Conclusion: Device-assisted catheterization may improve first-attempt success and reduce procedure time in neonates. Evidence on safety is limited. Due to variability in study methodologies and outcome reporting, high-quality RCTs with standardized outcome measures are needed.</p>}},
  author       = {{Shcherbatiuk, Kristina and Magagnoli, Clelia and Susca, Francesco and Caratozzolo, Daniele and Fiander, Michelle and Soll, Roger Franklin and Bruschettini, Matteo and Romantsik, Olga}},
  issn         = {{1661-7800}},
  keywords     = {{Catheterization; Devices; Neonates; Success; Systematic review}},
  language     = {{eng}},
  pages        = {{1--17}},
  publisher    = {{Karger}},
  series       = {{Neonatology}},
  title        = {{Devices for Neonatal Peripheral Catheterization and Tip Confirmation : A Systematic Review and Meta-Analysis}},
  url          = {{http://dx.doi.org/10.1159/000549323}},
  doi          = {{10.1159/000549323}},
  year         = {{2025}},
}