Safety of Short-Term Parenteral Nutrition Administration Through Umbilical Artery Catheters in Neonates While in the Neonatal Intensive Care Unit.

Abstract

Objective: The use of umbilical artery catheters (UACs) for parenteral nutrition (PN) administration is controversial, and limited data exist on the safety of administration through this route. The objective of this research is to evaluate neonates who received PN through a UAC and assess catheter-related complications and PN composition.

Methods: This retrospective study evaluated all neonates who received PN through their UAC while admitted in the neonatal intensive care unit between January 2019 and December 2022. Neonates were evaluated for development of catheter-related complications such as infiltration, extravasation, thrombus formation, infection, or hypertension.

Results: The administration of PN through UAC was identified in 31 neonates. Among the 31 neonates, 17 (55%) were classified as preterm, and 15 (48%) were classified as low birth weight. No patient experienced a UAC-related complication. Death occurred among 7 (23%) neonates. Two deaths occurred while the neonates were receiving PN via the UAC, but neither death was attributed to UAC complications. In 19 (61%) of the 31 neonates, osmolarity of PN exceeded 900 mOsm/L.

Conclusions: Results of this study suggest that UACs may serve as a safe route for PN administration in neonates. The absence of catheter-related complications and the absence of adverse events support the safety of this approach. Further research with a larger sample size and rigorous study design is warranted to validate these findings and establish guidelines for the use of UACs in PN administration.