Lines are used for many purposes in neonates. The most common use is to administer parenteral fluids. Withdrawing blood and monitor blood pressure are two more important things to consider. I will discuss the types and the use of common lines I used to deal with in my rotations in NICU.
Peripheral Intravenous Line: The most used type. It's used to administer fluids, medications or even parenteral fluids. Here, we're limited with the concentration and osmolarity of fluids being administered. We can't use high osmolarity fluids like: D15% W or more.
Peripheral Arterial Line: It's used for both arterial blood withdrawal and invasive blood pressure monitoring. The most common side is the radial artery. It's important to know how to manipulate the line carefully because they usually don't last long and it's painful to insert them again. Don't insert arterial line the the hypoperfused extremity.
Peripherally Inserted Central Catheter: This is a common practice. The line starts as peripheral IV but extends far to reach a central vessel. The cath usually is very thin. As we reach the central vascular system, we can use high osmolarity fluids as high dextro (>12.5%). The most common reason to use this is to secure a safe way to administer parenteral nutrition for baby. An x-ray is done post insertion to assess the position of the end of the catheter; it should be central but not in the heart!
Umbilical Venous Line: The most common central line used in the first week of life. It's administered right after birth if a line is needed for resuscitation. Later on, it's used most commonly for administration of parenteral nutrition. An abdominal x-ray is done post insertion to assess the position of the end of the cath before being used.
