Vascular access: lines and catheters
Lines and catheters, also referred to as “vascular access” devices, create an artificial opening from the outside world to the body’s blood circulation system, which is also called the vascular system. The most familiar type of vascular access is a peripheral intravenous line (PIV). An IV is essentially a small hollow tube that is placed in a vein and attached to a long tube that goes into an IV pump. In newborns, PIVs are usually put into a vein in the hand, foot, or scalp, allowing medical staff to give medicine or other fluids. PIVs are semi-permanent in that they can remain inserted without interruption, sometimes for a few days.
Vascular access for a premature baby follows the same principles. However, the different types of vascular access used are designed to be more gentle, accommodate the smaller veins of a premature baby, provide a regular flow of nutrition or medicine, and stay in for longer periods of time.
Premature babies are small, have a small volume of blood, and often have fragile skin. Most babies in the Neonatal Intensive Care Unit (NICU) require medicine, fluid, or nutrition to be given directly into the blood. Additionally, it is often necessary for babies in the NICU to have blood taken for tests, sometimes several times a day, depending on their condition. Vascular access technologies are designed to allow this with the minimum amount of discomfort for the baby and maximum ease for the medical staff.
The need for vascular access
There are three reasons why vascular access may be needed in a premature baby:
- Nutrition: usually total parenteral nutrition (TPN), which contains fat, essential vitamins, and nutrients. TPN is delivered directly into the bloodstream, bypassing the digestive system, either because it is immature and therefore unprepared to digest nutrition properly or because there is some other complication with the digestive system.
- Drawing blood: for tests, of which there are many different types
- Delivery of medicines: such as antibiotics and fluids for hydration directly to the bloodstream