Lanel Penelope, Bonnel Martin, Teillet Baptiste, Bellanger Claire, Kermorvant-Duchemin Elsa, Lapillonne Alexandre, Sartorius Victor
Department of neonatal intensive care, Hôpital Necker-Enfants malades, AP-HP, Paris, France.
Université Paris Cité, Paris, France.
Eur J Pediatr. 2025 Aug 26;184(9):575. doi: 10.1007/s00431-025-06375-3.
The aim of this study is to assess the use of centrally and femorally inserted central catheters (CICCs and FICCs, respectively) in French neonatal intensive care units (NICUs) and to describe associated clinical practices. We conducted a national cross-sectional survey targeting all level III or higher NICUs in France. A link to an online questionnaire was sent to one member of the medical team in each unit between September and December 2024. CICCs were defined as central catheters inserted via the brachiocephalic or the internal jugular vein, and FICCs as central catheters inserted via the common femoral vein. All 65 NICUs participated in the survey. Of these, 45 (69.2%) reported performing CICC or FICC placements. Specifically, 35 (53.8%), 39 (60.0%), and 37 (56.9%) units performed insertions via the brachiocephalic vein, internal jugular vein, and common femoral vein, respectively. In most units, CICC/FICCs were used most frequently (n = 20) or systematically (n = 18) as a second-line option after an epicutaneo-caval catheter had been considered. In units that use CICC/FICCs, placement was performed by a NICU physician in 39 (86.7%) of them. In most cases, the catheter was placed under conscious sedation when feasible. The median minimum patient weight [interquartile range] considered suitable for central catheter placement was 1500 [800-2000] grams for brachiocephalic catheters, 1500 [900-2000] grams for internal jugular catheters, and 1650 [800-2000] grams for common femoral catheters. Very small caliber catheters (1 or 2 French in diameter) and a modified Seldinger insertion technique were used in 23 and 17 units, respectively.
CICC/FICCs use is part of clinical practice in most French NICUs, mainly as a second-line option. Indications for use, placement techniques, and maintenance protocols vary across units.
• Previous studies from specialized centers have shown that centrally and femorally inserted central catheters (CICC/FICCs) can be safely inserted in neonates. •It is still unclear to what extent these practices have been implemented in neonatal intensive care units.
• CICC/FICCs are now part of clinical practice in the majority of French NICUs. • The median minimum weight for CICC/FICC insertion was approximately 1500 g, indicating that their use has extended to smaller, more vulnerable infants. Very small-diameter catheters combined with a modified insertion technique enhance compatibility with neonatal vasculature.
本研究旨在评估法国新生儿重症监护病房（NICUs）中经中心静脉和股静脉插入的中心静脉导管（分别为CICC和FICC）的使用情况，并描述相关的临床实践。我们针对法国所有三级及以上的NICUs进行了一项全国性横断面调查。2024年9月至12月期间，向每个单位的一名医疗团队成员发送了一份在线问卷链接。CICC被定义为经头臂静脉或颈内静脉插入的中心静脉导管，FICC被定义为经股总静脉插入的中心静脉导管。所有65个NICUs都参与了调查。其中，45个（69.2%）报告进行了CICC或FICC置管。具体而言，分别有35个（53.8%）、39个（60.0%）和37个（56.9%）单位通过头臂静脉、颈内静脉和股总静脉进行置管。在大多数单位中，CICC/FICC最常（n = 20）或系统地（n = 18）作为在考虑使用经皮腔静脉导管后的二线选择。在使用CICC/FICC的单位中，39个（86.7%）由NICU医生进行置管。在大多数情况下，可行时在清醒镇静下放置导管。对于头臂静脉导管，认为适合中心静脉导管置管的最小患者体重中位数[四分位间距]为1500[800 - 2000]克，颈内静脉导管为1500[900 - 2000]克，股总静脉导管为1650[800 - 2000]克。分别有23个和17个单位使用了非常小口径的导管（直径为1或2法国规格）和改良的Seldinger插入技术。
在大多数法国NICUs中，CICC/FICC的使用是临床实践的一部分，主要作为二线选择。各单位的使用指征、置管技术和维护方案各不相同。
• 来自专业中心的先前研究表明，经中心静脉和股静脉插入的中心静脉导管（CICC/FICC）可安全地插入新生儿体内。• 这些实践在新生儿重症监护病房中的实施程度仍不清楚。
• CICC/FICC现在是大多数法国NICUs临床实践的一部分。• CICC/FICC插入的最小体重中位数约为1500克，这表明其使用已扩展到更小、更脆弱的婴儿。非常小直径的导管与改良的插入技术相结合，增强了与新生儿血管系统的兼容性。
