Central venous catheters in surgical neonates

Area of Science:

• Neonatal Surgery
• Pediatric Critical Care
• Vascular Access Devices

Background:

• Central venous catheters (CVCs) are essential for neonatal care but associated with significant risks.
• Surgical neonates present unique challenges for CVC insertion and management.
• Previous studies highlight CVC complications, necessitating further investigation in specific neonatal populations.

Purpose of the Study:

• To evaluate the complication rates and incidence of central venous catheter (CVC) use in surgical neonates.
• To identify factors contributing to CVC-related complications in this high-risk group.
• To compare complication rates between CVCs inserted in neonatal units versus surgical theaters.

Main Methods:

• Retrospective analysis of 65 CVC insertions in 55 surgical neonates over a 4-year period.
• Data collection included catheter dwell time, insertion site, catheter type, and documented complications.
• Complication incidence was calculated per catheter day and analyzed in relation to patient diagnosis and insertion setting.

Main Results:

• Overall complication rate was 34% (22/65 lines), with primary catheter sepsis occurring in 11% (7/65 lines).
• The infection incidence was 1:125 catheter days, with one mortality attributed to catheter sepsis.
• Insertion setting (neonatal unit vs. surgical theater) did not significantly alter complication rates, but incidence per day was higher than reported benchmarks.

Conclusions:

• Central venous catheter use in surgical neonates is associated with a substantial complication rate, including sepsis.
• The higher complication incidence per day suggests potential influences of patient pathology, surgical/nursing techniques, or catheter type.
• Further research is needed to optimize CVC management and reduce complications in this vulnerable population.