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Complications associated with central venous catheters inserted in critically ill neonates
V Hruszkewycz1, P C Holtrop, D G Batton
1Department of Epidemiology, William Beaumont Hospital, Royal Oak, Michigan 48073.
Infection Control and Hospital Epidemiology
|September 1, 1991
Summary
Central venous catheters (CVCs) are frequently associated with complications in critically ill infants, including dislodgement, occlusion, and infection. Their use should be limited to cases where alternative intravenous access is not feasible.
Area of Science:
- Neonatal Intensive Care
- Pediatric Critical Care
- Vascular Access Devices
Background:
- Central venous catheters (CVCs) are essential for managing critically ill neonates.
- However, their use is associated with potential complications that require careful monitoring.
Purpose of the Study:
- To determine the incidence and types of complications related to CVC placement in critically ill infants.
- To identify risk factors for CVC-associated infections in this population.
Main Methods:
- A prospective study was conducted in a neonatal intensive care unit (NICU) over one year.
- Data were collected on neonates requiring CVC insertion, with a case-control analysis for infection risk factors.
Main Results:
- Of 263 neonates, 13 (4.9%) received CVCs, totaling 600 catheter days.
- Complications occurred in 88% of CVCs, including dislodgement, occlusion, infection, and bleeding.
- The bloodstream infection rate was 1 episode per 100 catheter days, with younger gestational age and lower birth weight being risk factors for infection.
Conclusions:
- Central venous catheters (CVCs) are associated with a high rate of complications in critically ill neonates.
- CVC use should be reserved for infants where alternative intravenous access is not possible due to the significant risks involved.