The effect of umbilical venous catheterization on splanchnic oxygenation in preterm infants: A prospective cohort...

Umbilical venous catheter (UVC) placement is a common invasive procedure in preterm infants. Its potential effects on splanchnic oxygenation and feeding tolerance remain unclear. We hypothesized that UVC placement may alter splanchnic oxygenation and impact feeding tolerance.

In this prospective, single-center observational cohort study, regional splanchnic oxygen saturation (rSO₂S) was monitored using near-infrared spectroscopy in preterm infants (<34 weeks gestation, 1000-2000 g) during the first week of life. Infants were grouped by UVC placement [UVC (+)] or absence [UVC (-)]. Daily and longitudinal rSO₂S trends were analyzed. Clinical outcomes included enteral feeding milestones, duration of parenteral nutrition, feeding intolerance (FI), and necrotizing enterocolitis (NEC).

Forty-eight infants were included (23 UVC (+), 25 UVC (-)). There were no significant differences between groups in overall daily rSO₂S values, FI, or NEC incidence. FI occurred more frequently while UVCs were in place (p < 0.05). No significant changes in rSO₂S were observed before or after UVC insertion or removal. SGA infants in the UVC (+) group showed lower rSO₂S on Days 4, 6 and 7, whereas no differences were observed in the UVC (-) group. UVC (+) infants had later initiation of enteral feeding, longer time to full feeds, and prolonged parenteral nutrition.

UVC placement did not significantly alter overall splanchnic oxygenation during the first week of life. FI was more frequent during UVC use, but causality cannot be confirmed. Findings in SGA infants suggest possible vulnerability to reduced rSO₂S during UVC exposure, warranting confirmation in larger studies.