Umbilical artery catheters in the newborn: effects of catheter materials.

BACKGROUND

This section is under preparation and will be included in the next issue.

OBJECTIVES

To determine whether the material used for construction of an umbilical arterial catheter influences the frequency of ischemic events, aortic thrombosis, mortality or necrotising enterocolitis in newborn infants.

SEARCH STRATEGY: Randomized and quasi randomized controlled trials of umbilical catheterization use were obtained from the following sources: 1. Effective Care of the Newborn Infant, edited by JC Sinclair and MB Bracken. 2. Medline Search using Melvyl Medline Plus and the keyword headings "Umbilic#", "Catheter#" and subject heading "Infant, Newborn" 3. Search of personal data files

SELECTION CRITERIA: Randomized studies in newborn infants of any birthweight or gestation. Comparison of different catheter materials. Clinically important end points such as ischemic events, aortic thrombosis, or catheter occlusion.

DATA COLLECTION AND ANALYSIS: One non-randomized and one randomized study were retrieved.

MAIN

RESULTS

There were no significant effects of substituting a heparin bonded polyurethane catheter for the standard PVC catheter. The non-randomized study suggested that there may possibly be a benefit of using a catheter constructed from Silastic, with a reduction in aortic thrombosis.

REVIEWER'S

CONCLUSIONS

There are no demonstrated clinically relevant differences in outcomes between the use of PVC catheters and other materials. Therefore, other considerations such as price and ease of availability may dictate the catheter chosen. An adequately powered randomized comparison of silastic to PVC should be performed.