Malposition Rate With Varying Umbilical Vein Catheter Sizes in VLBW Neonates: A Randomized Controlled Trial
Bhargavi Gohil, Haribalakrishna Balasubramanian, Nandkishor Shrikishanji Kabra, Javed Ahmed, Swarup Dash, Gaurang Raval
Abstract
Aim: To compare the effect of 3.5 versus 5 French umbilical vein catheters (UVC) on the frequency of catheter tip malpositioning in very-low-birth-weight (VLBW) neonates
Materials and Methods: VLBW neonates requiring umbilical vein access in the first week of life were randomized for catheterization with either 3.5 Fr or 5 Fr single-lumen UVC. The catheters were considered appropriately positioned if the tip was visualized between T8 and T10 vertebral level on anteroposterior thoracoabdominal X-ray.
Results: A total of 70 neonates (34 in the 3.5 Fr and 36 in the 5 Fr groups) were studied. Baseline characteristics were similar in the study groups. The primary outcome was the rate of catheter tip malposition in both groups—65% of the 3.5 Fr catheters and 67% of the 5 Fr catheters were malpositioned (RR = 0.97, 95% CI: 0.69–1.36, P = 1.00). There were no differences in the rates of catheter malfunction, catheter-associated complications, and blood stream infections between the study groups.
Conclusion: The malposition of the tip of the UVC was not related to the size of the catheter. Considering the potential for complications with large catheters, the practice of using smallbore (3.5 Fr) UV catheters may be safe in VLBW neonates.
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