Comparison of risks from percutaneous central venous catheters and peripheral lines in infants of extremely low birth weight: a cohort controlled study of infants < 1000 g

Abstract

Objective: To evaluate in infants of < 1000 g (extremely low birth weight; ELBW ) the success rate of insertion of percutaneous central venous catheters (PCVC) and their duration; and the short-and long-term complications, i.e. mechanical and infectious, when compared to a control group of infants of the same age treated only with peripheral venous access. Study design: A cohort of 44 ELBW infantsmanaged with PCVC (study group) was compared to a cohort of 44 infants managed only with peripheral venous access (control group). The two groups were matched for birth weight, gestational age and gender,and were comparable for severity of illness (CRIB scores).Results: The success rate of PCVC insertion was 74% with the right axillary vein being the most frequently used site. The mean durationof PCVC treatment was 28 ± 13 days. The reasons for removal of the catheter were: cessation of the total parenteral nutrition administration in 75% of the cases and occlusion in 25%. There were threeinfectious episodes for a total of 1138 catheter days in the PCVC group vs. 12 episodes for a total of 1114 days (p = 0.03) in the control group. Three infants died in the study group and 11 infantsdied in the control group (p = 0.05) of infants of ELBW.Conclusion: Insertion of PCVC is successful in the vast majority of cases and carries a lower risk of infection than multiple insertionsof peripheral lines in infants of ELBW. It prevents repeat and painful introductions of intravenous needles.