Randomized trial of percutaneous central venous lines versus peripheral intravenous lines

Objective: To compare the occurrence of systemic infection or death in preterm infants with elective percutaneous central line (PCVL) placement versus peripheral intravenous catheter (PIV) placement. Study design: A total of 96 infants ≤1250 g or ≤30 weeks gestation were randomized by 4 days of age to elective placement of a PCVL or continued use of PIV catheters. The primary outcome of systemic infection (defined as a positive blood or cerebrospinal fluid (CSF) culture treated for at least 5 days) or death was monitored until the infants did not require intravenous (iv) support for 7 consecutive days. Results: Systemic infection or death occurred in 17/46 (39%) infants in the PCVL group and 14/50 (28%) in the PIV group (relative risk (RR) = 1.32 with 95% confidence interval (CI) 0.70, 2.53; risk difference (RD) = 0.09 with 95% CI b0.10, 0.28). The PCVL group had significantly fewer skin punctures for iv access. Conclusion: There was no significant difference in systemic infection or death (expressed either as a combined outcome or as separate component outcomes) between the groups. The number of skin punctures was significantly reduced in the PCVL group.