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Complications associated with surgically placed central venous catheters in low birth weight neonates
P B Pandit1, F A Pandit, J Govan
1Department of Pediatrics, University of Toronto Perinatal Complex, Ontario, Canada.
Objective:
To determine the incidence of complications in low birth weight neonates with surgically inserted central venous catheters (CVCs).
Study Design:
Retrospective chart review of all neonates < or = 1500-gm birth weight from three tertiary care neonatal intensive care units who required CVC insertion.
Results:
A total of 112 CVCs was inserted in 104 neonates with birth weight of 798 (490 to 1380) gm, age 16 (3 to 179) days, for a duration of 21 (1 to 130) days. The birth weights of 85 neonates were < or = 1000 gm. One or more complications associated with the CVC occurred in 59 patients (57%). Sepsis was the commonest complication, with 43 episodes in 38 patients, at a rate of 14.5 episodes/1000 catheter days. Using regression analysis, sepsis was associated with birth weight, male sex, and the duration for which the CVC remained in place. Five of the nine who developed superior vena cava syndrome and/or pleural effusions died.
Conclusion:
CVCs can provide venous access that is durable. However, in the LBW neonate, and especially in those of < or = 1000 gm, there is a high incidence of associated complications.