Long versus conventional peripheral intravenous catheters to reduce venipunctures during hospital stay: A randomized controlled trial

Background: Selecting the most appropriate vascular access is crucial to minimizing catheter-related complications and repeated-venipunctures. The objective of this study is to evaluate whether the use of a long peripheral catheter (LPC), compared to short peripheral catheter (SPC), results in a different number of patients requiring repeated venipunctures for blood withdrawal. Method: Single-center, parallel arm interventional randomized controlled trial. Patients were randomized to receive either a conventional SPC or LPC, placed by trained Emergency Department nurses without ultrasound guidance. The primary endpoint was the proportion of patients requiring additional venipunctures during hospitalization. Secondary outcomes included time to persistent withdrawal occlusion (PWO) and time to catheter failure. This trial was registered with ClinicalTrials.gov (NCT06290284). Results: In total, 294 patients were randomly assigned to either the intervention or the control group. The catheter was successfully placed at the first attempt in 133/147 (90.5%) and 103/138 (74.6%) patients in the SPC and LPC arms, respectively. No significant difference was found between the two study arms in the proportion of patients requiring a venipuncture after SPC or LPC insertion: 85 out of 147 patients (57.8%) in the SPC group and 77 out of 138 patients (55.8%) in the LPC group (p = 0.73), with a mean adjusted difference of 3.5% (95% CI: −7.4% to 14.4%; p = 0.529). Time to catheter failure was 3.07 (1.96–5.90) and 4.72 (1.97–8.82) days in the SPC and LPC groups, respectively. However, time to PWO was significantly longer in the LPC group (median 1.9 vs 1.1 days, p = 0.006). Conclusion: Although LPCs did not significantly reduce the need for repeated venipunctures, they demonstrated more favorable performance in routine Emergency Department practice.