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Central venous catheters in low birth weight infants: incidence of related complications
1Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Providence 02902.
Insights
Central venous catheter complications are significantly higher in very low birth weight infants (<1000 gm). These infants experienced increased infectious and mechanical issues, necessitating cautious use of central venous catheters.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
- Infectious Diseases
Background:
- Central venous catheters are crucial for neonatal intensive care.
- Complications associated with central venous catheters can be severe, especially in vulnerable infant populations.
Purpose of the Study:
- To determine if very low birth weight (VLBW) and low birth weight (LBW) infants experience higher rates of central venous catheter-related complications compared to larger infants.
- To identify specific types of complications and causative organisms in these infants.
Main Methods:
- Retrospective chart analysis of 51 infants (gestational age 24-42 weeks, weight 0.43-12.2 kg) with 69 central venous catheter placements.
- Data collected on infectious and mechanical complications, total complications, and infection-related complications.
Main Results:
- Infants weighing <1000 gm at catheter insertion had significantly greater infectious, mechanical, and total complications (p < 0.05).
- Oxacillin-resistant coagulase-negative Staphylococcus caused 82% of catheter-related septicemia episodes (14/17).
- Catheter salvage was unsuccessful in septic episodes treated solely with antibiotics without removal.
Conclusions:
- Central venous catheters are associated with high complication rates in VLBW (85%) and LBW (64%) infants.
- These devices should be used with extreme caution in VLBW and LBW neonates due to increased risks.
Abstract:
To test the hypothesis that the incidence of central venous catheter-related complications is increased in very low (< 1000 gm) and low (1001 to 1500 gm) birth weight infants compared with larger infants, we retrospectively analyzed the charts of 51 infants with gestational ages 24 to 42 weeks, weighing 0.43 to 12.2 kg at catheter insertion, who had 69 catheters placed at 1 week to 11 months of age between January 1986 and June 1989 at our hospitals. The incidence of infectious and mechanical complications and the frequency of total and infection-related complications were significantly greater for infants weighing < 1000 gm at catheter insertion (p < 0.05). Oxacillin-resistant coagulase-negative Staphylococcus organisms accounted for 14 of the 17 episodes of catheter-related septicemia (82%). Six of these episodes were initially treated with antibiotics but without catheter removal; none resolved with catheter salvage. Central venous catheters in very low and low birth weight infants had an 85% and 64% incidence of associated complications, respectively, and should be used with caution in these patients.