Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study (2024)

Gibson, K., Smith, A., Sharp, R., Ullman, A., Morris, S., & Esterman, A. (2024). Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study. Australian Critical Care, 37(5), 747-754. https://doi.org/10.1016/j.aucc.2024.01.013

Gibson, Kim ; Smith, Amber ; Sharp, Rebecca et al. / Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit : A retrospective cohort study. In: Australian Critical Care. 2024 ; Vol. 37, No. 5. pp. 747-754.

@article{24901a9677864103aff43f7c0f83e203,

title = "Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study",

abstract = "Background: Umbilical catheters are commonly inserted in newborns in the neonatal intensive care unit (NICU) yet are associated with serious adverse events (AEs) such as malposition, migration, infection, thrombosis, hepatic complications, cardiac effusion, and cardiac tamponade. There is a need to determine the incidence and risk factors for AEs to inform safe practice.Objectives: The objective of this study was to determine the incidence and risk factors for AEs (all-cause and individual types) associated with umbilical venous catheters (UVCs) and umbilical arterial catheters (UACs) in the NICU.Methods: A retrospective cohort study was conducted in an Australian level-VI NICU over a 3-year period. Any newborn who had both a UVC and UAC insertion attempt was included.Results: There were 236 neonates who had 494 catheters (245 UVCs and 249 UACs). Of these, 71% of UVCs (95% confidence interval [CI]: 65.6–76.9%; incidence rate: 181.1–237.3 per 1000 catheter days) and 43.8% of UACs (95% CI: 38–50.5%; incidence rate: 102.0–146.3 per 1000 catheter days) were associated with an AE. The most common AE was malposition on first X-ray for UVCs (60.1%, 95% CI: 55.1–67.3) and UACs (32.6%, 95% CI: 26.8–39.6). A dwell time of ≥7 days was a significant predictor of UAC failure (incidence risk ratio: 1.5, 95% CI: 1.1–2.1, p = 0.006) and migration of the UVC (incidence risk ratio: 3.5, 95% CI: 1.0–11.5, p = 0.043).Conclusion: Adverse events related to insertion occurred in a relatively high percentage of umbilical catheters placed. Increased dwell time remains a significant risk factor for catheter migration and overall failure. Practice change and consideration of risk factors for both individual and overall AE risk are necessary to reduce complications.",

keywords = "Catheterisation, Central venous, Infant, Neonate, Newborn, Umbilical arterial catheter, Umbilical venous catheter",

author = "Kim Gibson and Amber Smith and Rebecca Sharp and Amanda Ullman and Scott Morris and Adrian Esterman",

year = "2024",

month = sep,

doi = "10.1016/j.aucc.2024.01.013",

language = "English",

volume = "37",

pages = "747--754",

journal = "Australian Critical Care",

issn = "1036-7314",

publisher = "Cambridge Publishing",

number = "5",

}

Gibson, K, Smith, A, Sharp, R, Ullman, A, Morris, S & Esterman, A 2024, 'Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study', Australian Critical Care, vol. 37, no. 5, pp. 747-754. https://doi.org/10.1016/j.aucc.2024.01.013

Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study. / Gibson, Kim; Smith, Amber; Sharp, Rebecca et al.
In: Australian Critical Care, Vol. 37, No. 5, 09.2024, p. 747-754.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit

T2 - A retrospective cohort study

AU - Gibson, Kim

AU - Smith, Amber

AU - Sharp, Rebecca

AU - Ullman, Amanda

AU - Morris, Scott

AU - Esterman, Adrian

PY - 2024/9

Y1 - 2024/9

N2 - Background: Umbilical catheters are commonly inserted in newborns in the neonatal intensive care unit (NICU) yet are associated with serious adverse events (AEs) such as malposition, migration, infection, thrombosis, hepatic complications, cardiac effusion, and cardiac tamponade. There is a need to determine the incidence and risk factors for AEs to inform safe practice.Objectives: The objective of this study was to determine the incidence and risk factors for AEs (all-cause and individual types) associated with umbilical venous catheters (UVCs) and umbilical arterial catheters (UACs) in the NICU.Methods: A retrospective cohort study was conducted in an Australian level-VI NICU over a 3-year period. Any newborn who had both a UVC and UAC insertion attempt was included.Results: There were 236 neonates who had 494 catheters (245 UVCs and 249 UACs). Of these, 71% of UVCs (95% confidence interval [CI]: 65.6–76.9%; incidence rate: 181.1–237.3 per 1000 catheter days) and 43.8% of UACs (95% CI: 38–50.5%; incidence rate: 102.0–146.3 per 1000 catheter days) were associated with an AE. The most common AE was malposition on first X-ray for UVCs (60.1%, 95% CI: 55.1–67.3) and UACs (32.6%, 95% CI: 26.8–39.6). A dwell time of ≥7 days was a significant predictor of UAC failure (incidence risk ratio: 1.5, 95% CI: 1.1–2.1, p = 0.006) and migration of the UVC (incidence risk ratio: 3.5, 95% CI: 1.0–11.5, p = 0.043).Conclusion: Adverse events related to insertion occurred in a relatively high percentage of umbilical catheters placed. Increased dwell time remains a significant risk factor for catheter migration and overall failure. Practice change and consideration of risk factors for both individual and overall AE risk are necessary to reduce complications.

AB - Background: Umbilical catheters are commonly inserted in newborns in the neonatal intensive care unit (NICU) yet are associated with serious adverse events (AEs) such as malposition, migration, infection, thrombosis, hepatic complications, cardiac effusion, and cardiac tamponade. There is a need to determine the incidence and risk factors for AEs to inform safe practice.Objectives: The objective of this study was to determine the incidence and risk factors for AEs (all-cause and individual types) associated with umbilical venous catheters (UVCs) and umbilical arterial catheters (UACs) in the NICU.Methods: A retrospective cohort study was conducted in an Australian level-VI NICU over a 3-year period. Any newborn who had both a UVC and UAC insertion attempt was included.Results: There were 236 neonates who had 494 catheters (245 UVCs and 249 UACs). Of these, 71% of UVCs (95% confidence interval [CI]: 65.6–76.9%; incidence rate: 181.1–237.3 per 1000 catheter days) and 43.8% of UACs (95% CI: 38–50.5%; incidence rate: 102.0–146.3 per 1000 catheter days) were associated with an AE. The most common AE was malposition on first X-ray for UVCs (60.1%, 95% CI: 55.1–67.3) and UACs (32.6%, 95% CI: 26.8–39.6). A dwell time of ≥7 days was a significant predictor of UAC failure (incidence risk ratio: 1.5, 95% CI: 1.1–2.1, p = 0.006) and migration of the UVC (incidence risk ratio: 3.5, 95% CI: 1.0–11.5, p = 0.043).Conclusion: Adverse events related to insertion occurred in a relatively high percentage of umbilical catheters placed. Increased dwell time remains a significant risk factor for catheter migration and overall failure. Practice change and consideration of risk factors for both individual and overall AE risk are necessary to reduce complications.

KW - Catheterisation

KW - Central venous

KW - Infant

KW - Neonate

KW - Newborn

KW - Umbilical arterial catheter

KW - Umbilical venous catheter

UR - http://www.scopus.com/inward/record.url?scp=85188012093&partnerID=8YFLogxK

U2 - 10.1016/j.aucc.2024.01.013

DO - 10.1016/j.aucc.2024.01.013

M3 - Article

C2 - 38485556

AN - SCOPUS:85188012093

SN - 1036-7314

VL - 37

SP - 747

EP - 754

JO - Australian Critical Care

JF - Australian Critical Care

IS - 5

ER -

Gibson K, Smith A, Sharp R, Ullman A, Morris S, Esterman A. Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: A retrospective cohort study. Australian Critical Care. 2024 Sept;37(5):747-754. Epub 2024 Mar 13. doi: 10.1016/j.aucc.2024.01.013