Central venous catheters in very low birthweight infants: results from a national survey.

BACKGROUND

Central venous catheters (CVCs) are commonly used in preterm infants. They ensure secure vascular access but are also linked to relevant complications such as catheter-associated infections. Data on CVC practice in neonatal intensive care units (NICUs) are scarce, and management has rarely been comprehensively evaluated to date.

AIM: To evaluate daily practice of CVC usage in German tertiary level NICUs.

METHODS

Using a web-based survey, all 163 tertiary level NICUs in Germany were asked to provide information on local CVC practices, including indications, catheter types, and infection prevention measures.

FINDINGS: Anonymized data from N = 88 NICUs were analysed (response rate: 54%). Difficult venous access (85%) as well as administration of inotropes (90%) or parenteral nutrition (84%) were named as the most common reasons for CVC insertion. Peripherally inserted central catheters were the preferred catheter type (90-91% in weeks 1-2). Bloodstream infections were identified as the most frequent catheter-associated complication (65%). Key infection prevention measures highlighted by participants included strict hygiene upon catheter insertion (93%) and handling (83%) as well as early catheter removal (90%). However, practices varied significantly across units, particularly regarding skin antisepsis, routine dressing and catheter changes, antimicrobial prophylaxis, and device stewardship.

CONCLUSION

This survey provides a comprehensive overview of CVC use in German NICUs. It reveals significant variations in practices, reflecting both adherence to and deviations from national recommendations, thereby emphasizing areas of strength as well as opportunities for improvements, such as benchmarking for device stewardship.