Complications following umbilical vein catheterization in preterm neonates – single-center experience

Document Type : Original Article

Authors

1 Pediatric Clinic, Institute of Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia

2 Medical Faculty University of Novi Sad, Serbia Institute of Child and Youth Healthcare of Vojvodina, Novi Sad, Serbia

10.22038/ijn.2024.76968.2489

Abstract

Background. Despite their widespread use, umbilical venous catheters (UVCs) are associated with various complications.

Methods. This single-center retrospective cohort study examined UVC-related complications in preterm neonates within a tertiary Neonatal Intensive Care Unit (NICU) from January 2020 to December 2022. The study aimed to analyze these complications in relation to UVC positioning.

Results. Over the course of three years, 146 preterm neonates underwent UVC insertion. The cohort's mean gestational age was 29.2 ± 3 weeks, with a median birth weight of 1110 g (817-1482 g). The median UVC placement duration was 8 days (6-10), totalling 1220 catheter days. Overall, 37% of the UVC placements were categorized as optimal, 35.6% as low-lying, 20.5% as high-lying, and 6.8% were categorized as malpositioned. The UVC-related complications occurred in 62 neonates (42.5%), with central line-associated bloodstream infection (CLABSI) in 8.2%, portal vein thrombosis (PVT) in 2.7%, pericardial effusion in 0.7%, and necrotizing enterocolitis (NEC) in 2.7% of neonates. The incidence of UVC-related complications was lowest with high-lying positions (23.3%), followed by optimal positioning (31.5%), low-lying (63.5%), and the highest in malpositioned UVCs (70%). UVC placement exceeding 8 days were significantly associated with increased complications.

Conclusion. The study highlights an elevated rate of complications associated with umbilical vein catheterization emphasizing the need for judicious use, especially in preterm neonates.

Keywords

Iranian Journal of Neonatology

Articles in Press, Accepted Manuscript
Available Online from 23 April 2024

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