[Use of double-lumen umbilical vein catheters in a neonatal intensive care unit].
BACKGROUND
The aim of the study was to compare the success/failure rate and complications of insertion into the umbilical vein, of either double-lumen catheters (Charrière diameter 04, length 13 and 30 cm) or single-lumen catheters (Charrière diameter 05, length 40 cm) in a population of neonates admitted to a neonatal intensive care unit. The numbers of insertions of additional peripheral venous catheters were also compared.


METHODS
The population was divided into two groups according to the severity of the respiratory failure. Group 1 (n = 52): normal hemodynamic parameters and moderate respiratory failure (FiO2 < 0.6): only single-lumen catheters were used. Group 2 (n = 56): low systemic pressure requiring vascular filling and/or inotropic drugs infusion and/or severe respiratory failure (FiO2 > 0.6): in this group, either single-lumen catheters or double-lumen catheters were inserted.


RESULTS
The success rate of insertion of double-lumen catheters and of single-lumen catheters were similar (61% vs 71%: P = 0.7). Nineteen double-lumen catheters were inserted in the group 2. The average duration of double-lumen umbilical catheterization was not significantly different from simple-lumen catheterization (4.9 +/- 2.2 vs 4.6 +/- 2.2 days). Complications relating to the umbilical venous catheterization were uncommon: three catheter obstructions (two with single-lumen catheter, one with double-lumen catheters), two nosocomial infections (both with single-lumen catheter), one hydropericardium (with single-lumen catheter). In group 2, more peripheral venous catheters were required during the first 72 hours of life after insertion of single-lumen catheter than after insertion of double-lumen catheters (average number of peripheral venous catheters per infant: 1.6 +/- 0.83 vs 1 +/- 0.35 respectively; P < 0.01).


CONCLUSIONS
Feasibility and complication rate of umbilical double-lumen catheters were similar to those of single-lumen catheters. The use of umbilical double-lumen catheters reduces the need of peripheral venous catheters.
Storme
L
L
Service de médecine néonatale, hôpital Jeanne-de-Flandre, CHRU, Lille, France.
Ouali
M
M
Ganga-Zandzou
P S
PS
Klosowski
S
S
Rakza
T
T
Fassler
C
C
Haouari
N
N
Kacet
N
N
Lequien
P
P
D002316:Cardiotonic Agents / Q000627:therapeutic use; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D003428:Cross Infection / Q000209:etiology; D004867:Equipment Design; D005240:Feasibility Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000188:drug therapy; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D010490:Pericardial Effusion / Q000209:etiology; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000188:drug therapy; D013203:Staphylococcal Infections; D013212:Staphylococcus epidermidis; D013499:Surface Properties; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D014471:Umbilical Veins
D002316:Cardiotonic Agents