Prolonged Intravenous Infusions-Reply

I am not certain of Dr Sussmane's meaning when he writes that the use of a peripherally inserted central catheter has certain advantages. I assume that he means advantages over traditional, surgically placed catheters, such as those used in our study. The two methods do not seem comparable for at least two reasons. First, surgically implanted catheters are intended for long-term therapy. The mean number of catheter-days in our patients was 10-fold greater than that in Dr Sussmane's series. Second, the youngest patient in Dr Sussmane's group was 7 years old, compared with a mean age of 2.5 years in the single-lumen group in our study. The percutaneous technique he describes is similar to that which we and others have reported for use in premature infants.^1,2 This technique certainly may facilitate short-term venous access. Nevertheless, I strongly urge that retrospective and, ideally, prospective, randomized studies be performed for the