Complications Associated with 2 Different Types of Percutaneously Inserted Central Venous Catheters in Very Low Birth Weight Infants

Objective.To identify the prevalence and risk factors for complications associated with percutaneously inserted central venous catheters (PICCs) and evaluate the effect of different catheter types and their indwelling time on catheter-related complications.Design.Retrospective cohort study.Setting.A 49-bed neonatal intensive-care teaching hospital in Taiwan.Patients.Between 2004 and 2007, 518 single-lumen PICCs (defined as “old type”) and 290 PICCs with a stiffening stylet and a thicker introducer (“new type”) were inserted in a total of 534 neonates with a birth body weight of 1,500 g or less.Results.Independent risk factors of catheter-related sepsis (CRS) were longer duration for PICC placement and PICC inserted at femoral site (compared with nonfemoral sites) (odds ratio [OR], 1.53 [95% confidence interval {CI}, 1.07-2.25]; P = .044). An independent predictor of catheter-related noninfectious complications was time spent for PICC insertion of more than 60 minutes (compared with less than 30 minutes) (OR, 1.96 [95% CI, 1.08-3.53]; P = .026). New-type PICCs were significantly associated with a higher rate of femoral site insertion, catheter-related noninfectious complications, and longer time for successful insertion than old-type PICCs. The hazard rates of CRS according to indwelling time, determined over 5-day periods by survival analysis, showed 0.05% for catheters in place for 4 days or less; 0.27% for 5-9 days; 0.40% for 10-14 days; 0.68% for 15-19 days; 1.18% for 20-24 days; 3.96% for 25-29 days; and 10.45% for 30 or more days.Conclusions.Different catheters do influence the complication rates. Spending more than 60 minutes for successful PICC insertion and PICCs indwelling for more than 30 days are associated with higher rates of catheter-related complications.

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Risk Factors of Catheter-related Bloodstream Infection With Percutaneously Inserted Central Venous Catheters in Very Low Birth Weight Infants: A Center's Experience in Taiwan

Pediatrics & Neonatology ◽

10.1016/s1875-9572(10)60065-4 ◽

2010 ◽

Vol 51 (6) ◽

pp. 336-342 ◽

Cited By ~ 28

Author(s):

Jen-Fu Hsu ◽

Ming-Horng Tsai ◽

Hsuan-Rong Huang ◽

Reyin Lien ◽

Shih-Ming Chu ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Bloodstream Infection ◽

Very Low Birth Weight ◽

Central Venous Catheters ◽

Central Venous ◽

Low Birth Weight Infants ◽

Catheter Related Bloodstream Infection

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Complication Rates With Central Venous Catheters Inserted at Femoral and Non-Femoral Sites in Very Low Birth Weight Infants

The Pediatric Infectious Disease Journal ◽

10.1097/inf.0b013e3181aa3a29 ◽

2009 ◽

Vol 28 (11) ◽

pp. 966-970 ◽

Cited By ~ 23

Author(s):

Ming-Horng Tsai ◽

Reyin Lien ◽

Jiunn-Wei Wang ◽

Hsuan-Rong Huang ◽

Chiao-Ching Chiang ◽

...

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Central Venous Catheters ◽

Complication Rates ◽

Central Venous ◽

Low Birth Weight Infants

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Prospective Evaluation of Percutaneous Central Venous Silastic Catheters in Newborn Infants With Birth Weights of 510 o 3,920 Grams

PEDIATRICS ◽

10.1542/peds.78.2.245 ◽

1986 ◽

Vol 78 (2) ◽

pp. 245-250 ◽

Cited By ~ 2

Author(s):

Manuel Durand ◽

Rangasamy Ramanathan ◽

Bruce Martinelli ◽

Milagros Tolentino

Keyword(s):

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Very Low Birth Weight ◽

Newborn Infants ◽

Central Venous Catheters ◽

Central Venous ◽

Low Birth Weight Infants ◽

A Prospective Study ◽

First Time ◽

Percutaneous Central Venous Catheters

With improved neonatal survival, especially of very low birth weight infants, our efforts should be directed toward reduction of morbidity. Sick preterm infants require total parenteral nutrition for prolonged periods of time due to extreme prematurity and feeding intolerance. However, the use of surgically placed Broviac catheters has been associated with a high complication rate. A prospective study of 53 percutaneous central venous Silastic catheterizations for administration of total parenteral nutrition was performed in 45 newborn infants. At the time of catheter insertion, 37 babies weighed less than 1,500 g and 19 weighed less than 1,000 g. Percutaneous central venous catheters were placed successfully the first time in 50 of 55 attempts. In three babies, insertion was successful on second attempt. The catheters remained in place for 25.4 ± 16.7 days ([mean ± SD] range two to 80 days). In babies weighing less than 1,000 g, the catheters remained in place for a longer period of time (34.0 ± 18.0; range 12 to 80 days). Sixty-six percent of the catheters were removed electively. There were four cases of bacteremia (7.5%), and the overall incidence of mechanical complications was 26.4%. We conclude that percutaneous central venous catheters can be used safely and effectively in newborn infants for prolonged administration of total parenteral nutrition, especially in neonates weighing less than 1,000 g.

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RETINOPATHY OF PREMATURITY AND RISK FACTORS IN VERY LOW BIRTH WEIGHT INFANTS IN A NEONATAL INTENSIVE CARE UNIT IN A UNIVERSITY HOSPITAL IN BRAZIL

10.26226/morressier.5b5f4339b56e9b005965b3b7 ◽

2018 ◽

Author(s):

Silvana NADER ◽

Paulo de Jesus NADER ◽

Tatiana Siviero

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Birth Weight ◽

Neonatal Intensive Care Unit ◽

Retinopathy Of Prematurity ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

University Hospital ◽

Low Birth Weight Infants

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Why Are We Trimming Peripherally Inserted Central Venous Catheters?

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.23.3.82 ◽

2004 ◽

Vol 23 (3) ◽

pp. 82-83 ◽

Cited By ~ 4

Author(s):

Carol Trotter

Keyword(s):

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Insertion Site ◽

Standard Of Care ◽

Central Venous Catheters ◽

Neonatal Intensive Care Units ◽

Central Venous ◽

Intravenous Access ◽

Catheter Insertion Site ◽

Catheter Tip

PERIPHERALLY INSERTED CENTRAL venous catheters (PICCs) are used as the standard of care for longterm intravenous access in neonates treated in neonatal intensive care units. Little evidence supports many of the practices associated with PICC lines, however. Some practices needing more evidence include catheter tip placement in very low birth weight neonates, the catheter insertion site, the catheter material, insertion site dressings, and mechanisms to prevent catheter-related sepsis. Of particular concern is the practice of trimming the excess length off the distal end of the catheter prior to insertion.

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Retinopathy of Prematurity: Incidence and Risk Factors

PEDIATRICS ◽

10.1542/peds.72.2.159 ◽

1983 ◽

Vol 72 (2) ◽

pp. 159-163 ◽

Cited By ~ 1

Author(s):

Mordechai Shohat ◽

Salomon H. Reisner ◽

R. Krikler ◽

Ilana Nissenkorn ◽

Yuval Yassur ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Retinopathy Of Prematurity ◽

Medical Records ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Low Birth Weight Infants ◽

Frequent Monitoring ◽

High Incidence ◽

Yearly Incidence

A high incidence of retinopathy of prematurity (ROP) was found in the very low-birth-weight infants discharged from the neonatal intensive care unit during the years 1977 to 1980, in spite of frequent monitoring of oxygen use. Although the yearly incidence of ROP in infants weighing <1,500 g varied between 35% to 36%, none were blind. The medical records of 65 infants with a birth weight between 501 and 1,250 g, surviving in 1979 to 1980, were reviewed in order to find risk factors for ROP. There were no significant differences between the 34 infants with ROP and the 31 infants who did not have ROP in mean birth weight or mean gestational age. Of 32 possible risk factors examined, the factors significantly associated with ROP were: apnea with mask and bag ventilation; prolonged parenteral nutrition; number of blood transfusions; and episodes of hypoxemia, hypercarbia, and hypocarbia. A highly significant association between hypocarbia and the development of severe ROP was found.

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Characteristics and risk factors for extrauterine growth retardation in very-low-birth-weight infants

10.21203/rs.2.15931/v1 ◽

2019 ◽

Author(s):

Xingli Zhao ◽

Li Ding ◽

Xiaoqian Chen ◽

Xueping Zhu ◽

Jian Wang ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Growth Retardation ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Multivariate Logistic Regression Analysis ◽

Feeding Intolerance ◽

Low Birth Weight Infants ◽

Extrauterine Growth Retardation

Abstract This study aimed to investigate the characteristics and risk factors for extrauterine growth retardation (EUGR) in very-low-birth-weight infants (VLBWIs). The medical records of 137 VLBWIs admitted to the neonatal intensive care unit between June 2015 and December 2017 were retrospectively reviewed. The patients were divided into EUGR (n = 92) and non-EUGR (n = 45) groups. The data of demographic and clinical characteristics was collected and the risk factors for EUGR were assessed by multivariate logistic regression analysis. Gestational age (OR = 0.573, P < 0.01), SGA (OR = 3.887, P = 0.022), feeding intolerance (OR = 4.632, P = 0.002), and calories supplied by amino acids at the 7 th day (OR = 0.786, P = 0.006) were independent high-risk factors for EUGR. EUGR in VLBWIs may be prevented by strategies including early lactation, providing special formulas to reduce feeding intolerance, and sufficient calorie provision.This study aimed to investigate the characteristics and risk factors for extrauterine growth retardation (EUGR) in very-low-birth-weight infants (VLBWIs). The medical records of 137 VLBWIs admitted to the neonatal intensive care unit between June 2015 and December 2017 were retrospectively reviewed. The patients were divided into EUGR (n = 92) and non-EUGR (n = 45) groups. The data of demographic and clinical characteristics was collected and the risk factors for EUGR were assessed by multivariate logistic regression analysis. Gestational age (OR = 0.573, P < 0.01), SGA (OR = 3.887, P = 0.022), feeding intolerance (OR = 4.632, P = 0.002), and calories supplied by amino acids at the 7 th day (OR = 0.786, P = 0.006) were independent high-risk factors for EUGR. EUGR in VLBWIs may be prevented by strategies including early lactation, providing special formulas to reduce feeding intolerance, and sufficient calorie provision.

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