Factors Associated with Umbilical Venous Catheter Malposition in Newborns: A Tertiary Center Experience
Issued Date
2022-12-01
Resource Type
ISSN
07351631
eISSN
10988785
Scopus ID
2-s2.0-85104447020
Pubmed ID
33853146
Journal Title
American Journal of Perinatology
Volume
39
Issue
16
Start Page
1805
End Page
1811
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Perinatology Vol.39 No.16 (2022) , 1805-1811
Suggested Citation
Soonsawad S., Kieran E.A., Ting J.Y., Alonsoprieto E., Panczuk J.K. Factors Associated with Umbilical Venous Catheter Malposition in Newborns: A Tertiary Center Experience. American Journal of Perinatology Vol.39 No.16 (2022) , 1805-1811. 1811. doi:10.1055/s-0041-1726385 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87205
Title
Factors Associated with Umbilical Venous Catheter Malposition in Newborns: A Tertiary Center Experience
Author's Affiliation
Other Contributor(s)
Abstract
Objective Umbilical venous catheters (UVC) are widely used in neonatal intensive care (NICU). Noncentral catheter position is known to be associated with multiple adverse complications; however, risk factors for catheter malposition are unclear. This work aimed to identify clinical risk factors and complications associated with UVC malposition in neonates admitted in an NICU. Study Design A retrospective chart review was performed of inborn babies admitted to BC Women's Hospital NICU with UVC inserted in their first 7 days between July 2016 and June 2018. Infant and maternal demographic, radiograph, UVC-related data, and complications were reviewed. Results A total of 257 infants had UVC placed; 158 (61%) and 99 (39%) were in central and noncentral positions after initial placement, respectively. Of initially central-placed UVCs, a further 35 (22%) were pulled back or migrated to malposition on follow-up X-ray. Multivariable logistic regression analysis revealed the use of larger UV (5 Fr) catheter (odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.1-5.6, p = 0.026) and escalation of respiratory support mode (OR: 1.7, 95% CI: 1.0-2.8, p = 0.049) as significant predictors of catheter malposition. Conclusion Noncentral UVC position as well as migration were common after initial placement in this cohort. The use of larger size UV catheters and increasingly invasive respiratory support were risk factors associated with higher incidence of UVC malposition. Ongoing surveillance of UVC position is thus recommended. Key Points More than one-third of UV catheters were not in central position after the initial placement. Large size UV catheters and increasingly invasive respiratory support were risk factors for UV malposition. High incidence of UVC migration was found after initial central placement, warranting surveillance.