Study draft: "UVC-You Will See" study: longer vs. shorter umbilical venous catheter (UVC) dwell time (6-10 vs. 1-5 days) in very premature infants with birth weight < 1250 g and/or gestational age < 30 weeks.

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Wiener medizinische Wochenschrift Pub Date : 2024-09-01 Epub Date: 2024-06-13 DOI:10.1007/s10354-024-01047-7
Sascha Meyer, Steffi Hess, Martin Poryo, Cihan Papan, Arne Simon, Silvia Welcker, Anne Ehrlich, Christian Ruckes
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引用次数: 0

Abstract

Background: Umbilical venous catheters (UVCs) are often used in preterm infants. Their use is associated with complications (infections, clot formation, organ injury). Very preterm infants with acquired bloodstream infection are at a higher risk for death and important morbidities (e.g., adverse neurodevelopmental outcomes). It is standard clinical practice to remove UVCs in the first days of life. Replacement of intravenous access is often performed using percutaneously inserted central catheters (PICCs). It is unclear whether serial central line use affects the rates of catheter-related complications.

Methods: A multicenter randomized controlled trial (random group assignment) was performed in 562 very premature (gestational age < 30 weeks) and/or very low birth weight infants (< 1250 g) requiring an UVC for administration of parenteral nutrition and/or drugs. Group allocation was random.

Hypothesis: A UVC dwell time of 6-10 days (281 infants) is not associated with an increased rate of central venous catheter (UVC, PICC)-related complications compared to 1-5 days (281 infants), and a longer UVC dwell time will significantly reduce the number of painful, invasive procedures associated with the need for vascular access as well as radiation exposure, use of antibiotics, and medical costs.

Primary outcome parameter: The number of catheter-related bloodstream infections and/or catheter-related thromboses and/or catheter-associated organ injuries related to the use of UVC/PICC was the primary outcome.

Conclusion: Extending the UVC dwell time may significantly reduce the number of painful invasive procedures, with the potential to positively impact not only long-term pain perception but also important social competencies (attention, learning, and behavior). Thus, the "UVC-You Will See" study has the potential to substantially change current neonatal intensive care practice.

研究草案:"UVC-You Will See "研究:在出生体重小于 1250 克和/或胎龄小于 30 周的极早产儿中,延长脐静脉导管(UVC)停留时间(6-10 天对 1-5 天)与缩短脐静脉导管停留时间(6-10 天对 1-5 天)的对比。
背景:脐静脉导管(UVC)常用于早产儿。其使用与并发症(感染、血栓形成、器官损伤)有关。患有后天性血流感染的极早产儿死亡和出现重要疾病(如不良的神经发育结果)的风险较高。标准的临床实践是在婴儿出生后的最初几天拔除 UVC。更换静脉通路通常使用经皮插入中心导管(PICC)。目前还不清楚连续使用中心静脉导管是否会影响导管相关并发症的发生率:多中心随机对照试验(随机分组)在 562 名早产儿(胎龄假设:与 1-5 天(281 名婴儿)相比,6-10 天(281 名婴儿)的紫外线停留时间与中心静脉导管(UVC、PICC)相关并发症发生率的增加无关,更长的紫外线停留时间将显著减少与血管通路需求相关的痛苦、侵入性操作的次数,以及辐射暴露、抗生素的使用和医疗成本:导管相关血流感染和/或导管相关血栓形成和/或与使用紫外线/PICC 相关的导管相关器官损伤的数量是主要结果:延长紫外线停留时间可显著减少痛苦的侵入性操作次数,不仅有可能对长期痛觉产生积极影响,还可能对重要的社会能力(注意力、学习和行为)产生积极影响。因此,"紫外线-你会看到 "研究有可能极大地改变当前的新生儿重症监护实践。
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来源期刊
Wiener medizinische Wochenschrift
Wiener medizinische Wochenschrift MEDICINE, GENERAL & INTERNAL-
CiteScore
2.50
自引率
0.00%
发文量
79
期刊介绍: ''From the microscope to clinical application!'', Scientists from all European countries make available their recent research results and practical experience through Wiener Medizinische Wochenschrift, the renowned English- and German-language forum. Both original articles and reviews on a broad spectrum of clinical and preclinical medicine are presented within the successful framework of thematic issues compiled by guest editors. Selected cutting-edge topics, such as dementia, geriatric oncology, Helicobacter pylori and phytomedicine make the journal a mandatory source of information.
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