Insertions of intravascular catheters may be the most common procedure that is performed in neonatal intensive care units (NICUs). Central venous catheters (CVCs) are used in neonates for administration of intravenous fluids, medications, total parenteral nutrition (TPN), and blood products and for blood sampling.
Umbilical venous catheters (UVCs) are recommended for newborns during the first days of life, as the insertion is relatively simple and carries a low risk of related complications. Traditionally, after 7–10 days, UVCs are usually replaced by peripherally inserted central catheters (PICCs). Next option is to insert a central venous line (CVL) in the femoral vein, the internal jugular vein or the subclavian vein.
Ultrasonography is increasingly used in central catheter insertion and control of the tip position to decrease the time taken for insertion, increase the success of line placement on the first attempt and reduce manipulations and X-ray exposure and overall complication rates.
Neonates have the highest risk for thrombosis among pediatric patients. The use of CVCs is the most common cause for thrombosis in neonates and infants.