Complications Following Umbilical Vein Catheterization in Preterm Neonates – Single-Center

Background: Despite their widespread use, umbilical venous catheters (UVCs) are associated with various complications. Methods: This single-center retrospective cohort study examined UVC-related complications in preterm neonates within a tertiary Neonatal Intensive Care Unit (NICU) from January ۲۰۲۰ to December ۲۰۲۲. The study aimed to analyze these complications in relation to UVC positioning. Results: Over the course of three years, ۱۴۶ preterm neonates underwent UVC insertion. The cohort's mean gestational age was ۲۹.۲ ± ۳ weeks, with a median birth weight of ۱۱۱۰ g (۸۱۷-۱۴۸۲ g). The median UVC placement duration was ۸ days (۶-۱۰), totalling ۱۲۲۰ catheter days. Overall, ۳۷% of the UVC placements were categorized as optimal, ۳۵.۶% as low-lying, ۲۰.۵% as high-lying, and ۶.۸% were categorized as malpositioned. The UVC-related complications occurred in ۶۲ neonates (۴۲.۵%), with central line-associated bloodstream infection (CLABSI) in ۸.۲%, portal vein thrombosis (PVT) in ۲.۷%, pericardial effusion in ۰.۷%, and necrotizing enterocolitis (NEC) in ۲.۷% of neonates. The incidence of UVC-related complications was lowest with high-lying positions (۲۳.۳%), followed by optimal positioning (۳۱.۵%), low-lying (۶۳.۵%), and the highest in malpositioned UVCs (۷۰%). UVC placement exceeding ۸ days were significantly associated with increased complications. Conclusion: The study highlights an elevated rate of complications associated with umbilical vein catheterization emphasizing the need for judicious use, especially in preterm neonates.

Keywords:

Complications , preterm neonate , Umbilical venous catheter