Long-term maintenance-related complications of brachiocephalic vein cannulations in neonates: A retrospective evaluation.

IF 1.7 4区医学 Q2 ANESTHESIOLOGY

Pediatric Anesthesia Pub Date : 2025-01-01 Epub Date: 2024-10-07 DOI:10.1111/pan.15018

Eser Simsek, Filiz Uzumcugil, Sule Yigit

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引用次数: 0

Abstract

Background: Neonates are relatively prone to immediate, early, and late complications related to central venous cannulation (CVC). Ultrasound-guided brachiocephalic vein (BCV) cannulation has proven to be safe in neonates. Although studies addressed the immediate and early complications of CVC via BCV in neonates, few explored long-term maintenance-related complications.

Aims: To evaluate the incidences of long-term maintenance-related complications including central line-associated blood stream infection (CLABSI), central line-associated thrombosis (CLAT), and mechanical complications (CLAMC) of nontunneled BCV cannulation in neonates and their relationship with patient and catheter-related factors.

Methods: This study included BCV cannulations of neonates with postconceptional age of ≤44 weeks performed between January 2018 and January 2023. The incidences of complications were determined. Correlations between complications and postconceptional age, body weight, indication for catheter placement, the size and side of the catheter, as well as catheter dwell time were analyzed.

Results: In total, 89 BCV cannulations performed in 71 neonates. The incidences were 19.3 [95%CI: 12.88-28.76] total complications, 5.9 [95%CI: 2.84-12.06] CLABSI, 3.4 [95%CI: 1.30-8.58] CLAT and 10.1 [95%CI: 5.76-17.49] CLAMC in 1000 catheter days. There were 23 (25.8%) total complications; 7 (7.9%) were CLABSI, 4 (4.5%) were CLAT, and 12 (13.5%) were CLAMC. The multivariate analysis revealed that prolonged dwell time was associated with high incidence of total complications [OR: 1.07, 95% CI: 1.00-1.14, p = .047] and the catheter of smaller size (3F in this study) was associated with higher incidence of CLABSI [OR: 8.91, 95% CI: 1.03-77.45, p = .047].

Conclusion: In this study, the prolonged dwell time and smaller sized catheter was found to be independent predictors of total complications and CLABSI, respectively. The independent predictive effects of postconceptional age and body weight should be addressed in larger studies as potential risk factors.

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新生儿肱脑静脉插管的长期维护相关并发症：回顾性评估

背景：新生儿相对容易出现与中心静脉插管（CVC）相关的即刻、早期和晚期并发症。事实证明，超声引导下的肱脑静脉（BCV）插管对新生儿是安全的。目的：评估新生儿非隧道式 BCV 插管的长期维护相关并发症（包括中心静脉相关血流感染（CLABSI）、中心静脉相关血栓形成（CLAT）和机械并发症（CLAMC））的发生率及其与患者和导管相关因素的关系：本研究纳入了 2018 年 1 月至 2023 年 1 月期间对受孕后年龄≤44 周的新生儿进行的 BCV 插管。确定了并发症的发生率。分析了并发症与受孕后年龄、体重、导管放置指征、导管尺寸和侧边以及导管停留时间之间的相关性：71名新生儿共进行了89次BCV插管。结果：71 名新生儿共进行了 89 次 BCV 插管，总并发症发生率为 19.3 [95%CI：12.88-28.76]，CLABSI 为 5.9 [95%CI：2.84-12.06]，CLAT 为 3.4 [95%CI：1.30-8.58]，CLAMC 为 10.1 [95%CI：5.76-17.49]。总并发症为 23 例（25.8%），其中 7 例（7.9%）为 CLABSI，4 例（4.5%）为 CLAT，12 例（13.5%）为 CLAMC。多变量分析显示，停留时间延长与总并发症发生率高相关[OR：1.07，95% CI：1.00-1.14，p = .047]，导管尺寸较小（本研究中为 3F）与 CLABSI 发生率较高相关[OR：8.91，95% CI：1.03-77.45，p = .047]：本研究发现，停留时间延长和导管尺寸变小分别是总并发症和 CLABSI 的独立预测因素。孕后年龄和体重作为潜在风险因素的独立预测作用应在更大规模的研究中加以探讨。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Anesthesia 医学-麻醉学

CiteScore

3.20

自引率

11.80%

发文量

222

审稿时长

3-8 weeks

期刊介绍： Devoted to the dissemination of research of interest and importance to practising anesthetists everywhere, the scientific and clinical content of Pediatric Anesthesia covers a wide selection of medical disciplines in all areas relevant to paediatric anaesthesia, pain management and peri-operative medicine. The International Editorial Board is supported by the Editorial Advisory Board and a team of Senior Advisors, to ensure that the journal is publishing the best work from the front line of research in the field. The journal publishes high-quality, relevant scientific and clinical research papers, reviews, commentaries, pro-con debates, historical vignettes, correspondence, case presentations and book reviews.