Papaverine prolongs patency of peripheral arterial catheters in neonates.
OBJECTIVE
To test the hypothesis that the continuous infusion of papaverine-containing solutions in peripheral arterial catheters would decrease the catheter failure rate and increase the functional duration of the catheter in neonates.


METHODS
In a prospective, randomized, placebo-controlled, masked trial, 82 catheters were placed in 70 neonates in the papaverine group and 98 catheters were placed in 71 neonates in the placebo group.


RESULTS
The catheters in the papaverine group remained functional for a significantly longer duration than those in the placebo group. The median (25th%, 75th%) time before catheter failure was 16.6 (9.5, 24.3) days in the papaverine group and 12 days (6.1, 18.2) in the placebo group ( P = .023; Cox proportional hazards model). There was no significant difference in the incidence of intraventricular hemorrhage (IVH) between groups, and there was no evidence of hepatic toxicity.


CONCLUSIONS
The continuous infusion of papaverine-containing fluids prolongs the patency of peripheral arterial catheters in neonates. In this small number of infants, we found no difference in the incidence of IVH or hepatic toxicity.
Griffin
M Pamela
MP
Department of Pediatrics, University of Virginia Health System, Charlottesville, VA 22908, USA. mpg7u@virginia.edu
Siadaty
Mir S
MS
D000925:Anticoagulants / Q000008:administration & dosage; D002406:Catheterization, Peripheral; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007261:Infusions, Intra-Arterial; D008297:Male; D010208:Papaverine / Q000008:administration & dosage*; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014654:Vascular Patency / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage*
D000925:Anticoagulants; D014665:Vasodilator Agents; D012965:Sodium Chloride; D006493:Heparin; D010208:Papaverine