If venous access is required up to 2 weeks, an epicutaneous-caval central venous catheter (ECC) can be used, inserted into the superficial veins.
The choice of vein will be guided by the RaSuVA protocol (Rapid Superficial Vein Assessment), which involves a systematic examination of the superficial veins of the newborn, from the foot to the head, first on the right side and then on the left side, evaluating the seven sites where it is most likely to identify a vein: (1 ) medial malleolus, (2) lateral malleolus, (3) retro popliteal area, (4) hand and wrist, (5) antecubital area, (6) preauricular zone, (7) post-auricular zone.
In infants with exhaustion of superficial veins or in newborns in which - although there are superficial peripheral veins available - the insertion of an ECC encounters repeated difficulties in positioning the tip, the positioning of a CICC or FICC will be indicated.