ABSTRACT
The umbilical vein catheterization is one of the most common interventions in neonates.Central line-associated bloodstream infections is a frequent complication of umbilical vein catheterization.It may lead to increased morbidity and mortality by 7% to 11%.At present, published literature on umbilical vein catheter-related bloodstream infections is limited in China.Our better knowledge of its epidemiology, risk factors and preventive measures could help to improve clinical practice and guide future research.
ABSTRACT
Objective Catheter tip displacement (CTD) after ultrasound-guided umbilical vein catheterization (UVC) in neonates may influence the effect of treatment .This study was to investigate the risk factors for CTD . Methods This study included 159 neonates undergoing ultrasound -guided UVC in our hospital between January 2015 and June 2017.We recorded the one-time suc-cess rate of UVC and the numbers of cases of CTD and non -CTD at 7 days after UVC, and analyzed the risk factors for CTD by univari -ate and multivariate logistic regression analyses . Results Ultrasound-guided UVC was successfully performed in 106 (66.67％) of the neonatal patients, who underwent ultrasonography and thoracic and abdominal X -ray examinations 7 days later.CTD was observed in 19 (17.93％) of the 106 neonates, including 5 cases of upward shift (4.72％) and 14 cases of downward shift (13.21％), while the other 87 ( 82.07％) were non-CTD cases.Statistically significant differences were found between the CTD and non -CTD groups in the gestational age, body mass, catheter external fixation, restlessness, catheter-tending time, and catheter shifting (P<0.05).Multivariate analysis showed that the gestational age (OR =-1.315, P =0.015),body mass (OR=-1.214, P=0.019), catheter external fixation (OR =2.164, P =0.007), restlessness (OR =1.354, P =0.014), catheter-tending time (OR=1.458, P=0.012), and catheter shifting (OR=2.016, P=0.010) were the risk factors for CTD after ul-trasound-guided UVC. Conclusion There are quite a few risk factors for CTD after ultrasound -guided UVC, which can be reduced by relevant preventive measures .
ABSTRACT
Objective To probe the application of umbilical vein catheterization among the verylow-birth-weight or the low-birth-weight children.Methods In this retrospective study,the clinical condition of the very-low-birth-weight or the low-birth-weight infants in neonatal intensive care unit who had umbilical vein catheterization from June 2011 to January 2013 was concluded.Results Sixty-three cases were successfully catheterized,of which 41 cases were catheterized in inferior vena cava(65.1％).The retention time was 4 to 21 days,with an average of 12.9 days.Eleven cases suffered unplanned extubation of the indwelling catheters,and eight of them were located in the umbilical vein.There were statistically significant differences of unplanned extubation rates among different location of the catheters (x2 =8.38,P ＜ 0.01).All cases were intubated within 36 hours after birth,and the intubation time was not positively correlated to the success rate of catheterization in the inferior vena cava (x2 =0.223,P ＞ 0.1).Suspected catheter-related infections occurred in 5 cases and the infection rate was 6.2/1000 per intravascular catheter day.After extubation,bacterial cultures of the tips of the catheters and blood were arranged.The results suggest that the bacterial culture of the catheter tip was positive in only 1 case(1.6％),and yeast-like fungus was positive in 1 case (1.6％),while the retention time and incidence of catheter-related infection had no significant corelation(x2 =0.075,P ＞ 0.95).Conclusion Umbilical vein catheterization could be used at the early stage in preterm (very) low-birth-weight infants.