Review of low-lying umbilical venous catheters

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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” El Ters et al (2018).

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.

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Reference:
El Ters, N., Claassen, C., Lancaster, T., Barnette, A., Eldridge, W., Yazigi, F., Brar, K., Herco, M., Rogowski, L., Strand, M. and Vachharajani, A. (2018) Central versus Low-Lying Umbilical Venous Catheters: A Multicenter Study of Practices and Complications. American Journal of Perinatology. December 19th.

doi: 10.1055/s-0038-1676482.

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