TY - JOUR
T1 - Central versus Low-Lying Umbilical Venous Catheters
T2 - A Multicenter Study of Practices and Complications
AU - El Ters, Nathalie
AU - Claassen, Colleen
AU - Lancaster, Thomas
AU - Barnette, Alan
AU - Eldridge, Whitney
AU - Yazigi, Flora
AU - Brar, Komalpreet
AU - Herco, Maja
AU - Rogowski, Lauren
AU - Strand, Marya
AU - Vachharajani, Akshaya
PY - 2019/1/1
Y1 - 2019/1/1
N2 - 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.
AB - 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.
KW - central
KW - complications
KW - infusates
KW - low-lying
KW - umbilical venous catheters
UR - http://www.scopus.com/inward/record.url?scp=85071983038&partnerID=8YFLogxK
U2 - 10.1055/s-0038-1676482
DO - 10.1055/s-0038-1676482
M3 - Review article
C2 - 30566998
AN - SCOPUS:85071983038
VL - 36
SP - 1198
EP - 1204
JO - American Journal of Perinatology
JF - American Journal of Perinatology
SN - 0735-1631
IS - 11
ER -