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"To compare the incidence of central line associated blood stream infections (CLABSI) with the use of umbilical venous catheters (UVC) as primary vascular access in preterm neonates with peripherally inserted central catheters (PICC)" Arun et al (2024).

CLABSI reduction in preterm neonates

Abstract:

Objective: To compare the incidence of central line associated blood stream infections (CLABSI) with the use of umbilical venous catheters (UVC) as primary vascular access in preterm neonates with peripherally inserted central catheters (PICC).

Methods: This was an open-label, two parallel-arm, randomized controlled trial which included hospitalized neonates with birth weight <1250g who required a central venous access on day 1 of life. The neonates were randomized to either UVC or PICC line and evaluated for the incidence of CLABSI.

Results: Of the total 238 eligible neonates, 128 and 110 neonates were randomized to the UVC and PICC groups, respectively. The baseline characteristics were comparable in both groups. There was no difference in the incidence of CLABSI among the UVC and PICC groups (21.1% vs 18.2%; P = 0.57). Neonates in the PICC group needed multiple attempts at insertion compared to those in the UVC group (43% vs 12%, P = 0.01); more time was needed for PICC line insertion [median (IQR) 20 (15, 40) vs 10 (5, 15] minutes, but had longer duration of the primary line [7 (4, 10) vs 5 (3, 7)] minutes. Early removal of the line for leakage was higher in the UVC group and local signs of inflammation were higher in the PICC group. The overall incidence of complications was similar between the groups (53% vs 45%, P= 1.00).

Conclusion: In preterm infants with a birth weight of less than 1250 grams, the incidence of CLABSI was similar in the UVC and PICC group when used as a primary central line. The overall complication rates were comparable in UVC and PICC.


Reference:

Arun S, Murki S, Vardhelli V, Deshabhotla S, Maram S, Vadije PR, Oleti TP. Comparison of UVC with PICC Line for Reducing Central Line Associated Blood Stream Infections in Preterm Neonates with Birth Weight < 1250g: An Open-Label Randomized Controlled Trial. Indian Pediatr. 2024 Sep 24:S097475591600701. Epub ahead of print. PMID: 39351837.

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