[Prospective evaluation of umbilical catheters in newborn infants. The Castrillo Hospital Group].
OBJECTIVE
To evaluate the current use of umbilical catheters in newborn infants in spain by analyzing technical characteristics and infections, as well as mechanical and local complications.


METHODS
Umbilical catheters inserted in newborns in the neonatal units of the hospitals in the Castrillo hospital group from july 15, 1998 to december 31, 1998 were collected for prospective analysis.


RESULTS
A total of 489 umbilical catheters (201 venous and 288 arterial) placed in 475 newborns were analysed. No difficulties were found in inserting the catheters and they had an average indwelling time of less than 5 days. Most were removed electively. A total of 461 (94.3%) catheter tips were sent for microbiological examination and cultures were positive in 98 (21.2%). Of these, catheter contamination was found in 85 (18.4%) and catheter related sepsis was confirmed in 11(2.4%). Staphylococcus epidermidis was the most commonly isolated organism (72.2% of contaminated catheters and 63.6% of catheter-related sepsis). The main risk factor for contamination was duration of catheterization >/= 3 days and that for cather related sepsis was duration of catheterization >/= 3 days and birth weight </= 1500g. Local or mechanical complications were documented in 7.9% of venous catheters and 9% of arterial catheters. The most common complications were accidental dislodgment in venous catheters (3.98%) and clinical vascular compromise in the lower extremities in arterial catheters (2.77%).


CONCLUSIONS
In our experience, the umbilical catheter had a low complication rate. To ensure that the benefits of catheterization outweigh the risks, prolonged use of these devices should be avoided.
D000367:Age Factors; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013997:Time Factors; D014469:Umbilical Arteries; D014471:Umbilical Veins