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Updated: Jan 11, 2026

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Inter-center variation in non-elective removal of central catheters amongst level 4 NICUs
Lauren A Beard1, Isabella Zaniletti2, Theresa R Grover3,2
1Children's Hospital Colorado and University of Colorado School of Medicine, Department of Pediatrics, Division of Neonatology, Aurora, CO, USA. Lauren.Beard@cuanschutz.edu.
Objective:
To quantify inter-center variation (ICV) in non-elective removal (NER) of central venous catheters (CVCs) in level 4 Neonatal Intensive Care Units (NICUs).
Study Design:
Using the Children's Hospitals Neonatal Database (CHND), we identified CVCs in infants admitted 2017-2023. The primary outcome was CVC NER, and the primary exposure was CHND center. We quantified unadjusted and adjusted ICV in NER.
Result:
We analyzed 71,865 patients and 135,671 CVCs. Median gestational age was 36 weeks and birth weight 2450 g. Over 50% infants (28,077) received >1 CVC. Centers placed 196-7120 catheters with a median dwell time of 7 (IQR 4-14) days. The overall NER rate was 11.7%, with significant ICV (unadjusted ICV: 3-19%, p < 0.001; adjusted center-level odds of NER: 0.26-2.03, p < 0.001).
Conclusion:
There is significant ICV in NER between level IV NICUs. Reducing modifiable NER may increase safety for patients with CVCs. Center-specific NER metrics may serve as clinical benchmarks.
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