Am J Perinatol 2019; 36(11): 1198-1204
DOI: 10.1055/s-0038-1676482
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Nathalie El Ters
1   Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
,
Colleen Claassen
2   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
,
Thomas Lancaster
3   Sunflower Neonatology Associates, Overland Park, Kansas
,
Alan Barnette
4   Department of Neonatology, Saint Francis Medical Center, Cape Girardeau, Missouri
,
Whitney Eldridge
1   Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
,
Flora Yazigi
2   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
,
Komalpreet Brar
2   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
,
Maja Herco
1   Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
,
Lauren Rogowski
1   Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
,
Marya Strand
2   Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University School of Medicine, St. Louis, Missouri
,
Akshaya Vachharajani
1   Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
› Author Affiliations
Funding None.
Further Information

Publication History

12 April 2018

21 October 2018

Publication Date:
19 December 2018 (online)

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Abstract

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.