Comparison of catheter-related infection and tip colonization between internal jugular and subclavian central venous catheters in surgical neonates.
BACKGROUND
The primary aim of this study was to compare catheter-associated infections and tip contaminations between percutaneously placed central venous catheters in the internal jugular and subclavian veins in surgical neonates undergoing major noncardiac surgery.


METHODS
The prospectively computerized protocols of 295 procedures were analyzed retrospectively.


RESULTS
One hundred twenty-nine internal jugular venous (group I) and 107 subclavian venous catheters (group S) were included. The median postconceptual age was 37 weeks in group I and 38 in group S. The weight ranged from 580 g to 4.5 kg in group I and from 820 g to 4.5 kg in group S at the time of insertion. Significantly more catheter-associated infections were observed in group I (15.5 vs. 4.7%; chi-square analysis: P < 0.01). The internal jugular venous catheters were also associated with a significantly increased probability of an earlier onset of a catheter-associated infection compared with the subclavian venous catheters (log rank test: P < 0.01; Cox model: P < 0.01). This probability was only slightly increased by a lower weight (Cox model: P = 0.075), and it was not increased by a lower age (Cox model: P = 0.93). Significantly more catheter tips were contaminated by pathogens in group I (55.8 vs. 33.6%; chi-square analysis: P < 0.01).


CONCLUSIONS
The internal jugular venous catheters were associated with a higher infection rate as well as earlier onset of catheter-associated infection compared with the subclavian venous catheters.
Department of Anesthesiology, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria. breschan.ch@chello.at
Christian
C
Breschan
Manuela
M
Platzer
Robert
R
Jost
Florian
F
Schaumberger
Haro
H
Stettner
Rudolf
R
Likar
D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods; D004866:Equipment Contamination; D006801:Humans; D007231:Infant, Newborn; D007601:Jugular Veins / Q000382:microbiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D013350:Subclavian Vein / Q000382:microbiology*; D019616:Thoracic Surgical Procedures / Q000295:instrumentation