The epicutaneous-caval catheters (ECC) are peripherally inserted central catheters inserted in superficial veins; they are different from ultrasound guided PICCs, which are peripherally inserted central catheters inserted in the deep veins of the arm.
The first choice material of ECC is polyurethane. The caliber is between 1Fr and 2.7Fr; there are also double lumen 2Fr ECC, although seldom used.
Insertion is performed by direct percutaneous cannulation of visible/palpable superficial veins, with or without the aid of the visualization by NIR (Near Infra-Red) technology.
Echocardiography plays an increasingly important role in the correct placement of such catheters, as a method of both tip navigation and tip location.
According to the latest evidence, ECC are appropriate when the expected duration of i.v. treatment does not exceed 2 weeks; due to the small size, they are not appropriate for blood sampling or for high flows or for hemodynamic monitoring: therefore, they should be used in stable newborns who need only intravenous hydration/nutrition.
In case of failure of the positioning of the ECC (lack of suitable peripheral veins, repeated malpositions, repeated ineffective attempts, etc.), a FICC or a CICC should be used.