Vascular access procedure trends in NICU
Abstract:
Objective: Identify the rates and trends of various procedures performed on newborns.
Study design: The HCUP database for the years 2002 to 2015 was queried for the number of livebirths, and various procedures using ICD-9 codes. These were adjusted to the rate of livebirths in each particular year. A hypothetical high-volume hospital based on data from the last 5 years was used to estimate the frequency of each procedure.
Results: Over the study period, there was a decline in the rates of exchange transfusions and placement of arterial catheters. There was an increase in the rates of thoracentesis, abdominal paracentesis, placement of UVC lines, and central lines with ultrasound or fluoroscopic guidance. No change was observed in the rates of unguided central lines, pericardiocentesis, bladder aspiration, intubations, and LP. Intubations were the most performed procedures. Placement of UVC, central venous lines (including PICCs), arterial catheters, and LP were relatively common, whereas others were rare such as pericardiocentesis and paracentesis.
Conclusions: Some potentially lifesaving procedures are extremely rare or decreasing in incidence. There has also been an increase in utilization of fluoroscopic / ultrasound guidance for the placement of central venous catheters.
Sammour I, Karnati S, Othman HF, Heis F, Peluso A, Aly H. Trends in Procedures in the Neonatal Intensive Care Unit. Am J Perinatol. 2022 Jul 20. doi: 10.1055/a-1905-5245. Epub ahead of print. PMID: 35858651.