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Central versus Low-Lying Umbilical Venous Catheters: A Multicenter Study of Practices and Complications.

Research paper by Nathalie N El Ters, Colleen C Claassen, Thomas T Lancaster, Alan A Barnette, Whitney W Eldridge, Flora F Yazigi, Komalpreet K Brar, Maja M Herco, Lauren L Rogowski, Marya M Strand, Akshaya A Vachharajani

Indexed on: 20 Dec '18Published on: 20 Dec '18Published in: American journal of perinatology



Abstract

 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.  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.  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.  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. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.