American journal of perinatology · 2018
Central versus Low-Lying Umbilical Venous Catheters: A Multicenter Study of Practices and Complications.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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El Ters Nathalie, Claassen Colleen, Lancaster Thomas, Barnette Alan, Eldridge Whitney, Yazigi Flora, Brar Komalpreet, Herco Maja, Rogowski Lauren, Strand Marya, Vachharajani Akshaya
Аннотация
OBJECTIVES: Conventional neonatology practice is to place umbilical venous catheters (UVCs) in central position and to limit the use of low-lying catheters. Our objectives were to describe the practices and complications associated with UVCs and to evaluate the type of infusates used with either UVC position.
STUDY DESIGN: A retrospective chart review was performed at four neonatal intensive care units to identify neonates who underwent UVC placement over a 2-year period. Infant demographics, UVC position, catheter days, fluid and medication characteristics, and specific complications were extracted.
RESULTS: A total of 2,011 neonates who underwent UVC placement were identified during the 2-year period. Of these, 641 UVCs (31.9%) were identified in the low-lying position. Centrally positioned UVCs were associated with lower gestational age and were left in situ for a longer duration than low-lying UVCs. Infusions of hyperosmolar solutions and vasopressors were significantly higher in central UVCs, though they were used in a significant number of low-lying UVCs. Complications, while not statistically different, were three times higher in low-lying UVCs.
CONCLUSION: Despite conventional teaching, low-lying UVCs were used in nearly one-third of infants in this cohort. Parenteral nutrition, antibiotics, and vasopressors were infused through central and low-lying UVCs. There was no statistically significant difference in complication rates between UVC positions.
STUDY DESIGN: A retrospective chart review was performed at four neonatal intensive care units to identify neonates who underwent UVC placement over a 2-year period. Infant demographics, UVC position, catheter days, fluid and medication characteristics, and specific complications were extracted.
RESULTS: A total of 2,011 neonates who underwent UVC placement were identified during the 2-year period. Of these, 641 UVCs (31.9%) were identified in the low-lying position. Centrally positioned UVCs were associated with lower gestational age and were left in situ for a longer duration than low-lying UVCs. Infusions of hyperosmolar solutions and vasopressors were significantly higher in central UVCs, though they were used in a significant number of low-lying UVCs. Complications, while not statistically different, were three times higher in low-lying UVCs.
CONCLUSION: Despite conventional teaching, low-lying UVCs were used in nearly one-third of infants in this cohort. Parenteral nutrition, antibiotics, and vasopressors were infused through central and low-lying UVCs. There was no statistically significant difference in complication rates between UVC positions.