Use of a Feeding Bundle Appears to Reduce Central Line Utilization in Neonates

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Clinical Nutrition

Background:

• Central line utilization is a significant concern in very low birth weight (VLBW) neonates.
• Reducing central line use is crucial for minimizing associated complications.
• Standardized feeding protocols may offer a strategy to decrease invasive device dependency.

Purpose of the Study:

• To evaluate the impact of a standardized feeding bundle on central line utilization in VLBW neonates.
• To assess changes in central line-associated bloodstream infections (CLABSIs) following the implementation of the feeding bundle.

Main Methods:

• A retrospective chart review was conducted for infants weighing ≤1500 g who required a central line between 2009 and 2012.
• Infants were stratified into three weight groups: ≤750 g, 751–1000 g, and 1001–1500 g.
• Central line utilization rates and CLABSI rates were analyzed before and after the feeding bundle implementation.

Main Results:

• Central line utilization significantly decreased across all weight strata (P < 0.001).
• Specifically, utilization dropped from 0.45 to 0.28 in infants ≤750 g, 0.4 to 0.27 in 751–1000 g infants, and 0.39 to 0.3 in 1001–1500 g infants.
• The rate of CLABSIs remained unchanged despite the reduction in central line use.

Conclusions:

• Implementation of a standardized feeding bundle is effective in reducing central line utilization in VLBW neonates.
• The feeding bundle did not demonstrate an effect on the incidence of CLABSIs.
• Further research may be needed to explore strategies for reducing CLABSIs concurrently with central line reduction.