title: Impact of umbilical catheterization on morbidity and mortality in extremely premature newborns.
abstract: OBJECTIVE
  Investigate the benefit of umbilical catheterization upon survival and selected morbidities in extremely premature newborns (<28 weeks gestation). Outcomes of successfully catheterized extremely premature newborns are compared with others who cannot be successfully catheterized, and we hypothesize that umbilical catheterization promotes survival and reduces morbidities.
  
  
  METHODS
  Utilizing a retrospective, cohort study design, survival and outcomes of catheterized and non-catheterized newborns (n = 722) were compared by univariate and multiple logistic regression analyses.
  
  
  RESULTS
  Of all newborns, 66.8% had both umbilical arterial catheter (UAC) and umbilical venous catheter (UVC) placements, 15.0% had only UAC, 13.7% had only UVC, and 4.6% had neither. Overall survival was 82.5%. Survivals with and without UAC were 82.5% and 82.6% (NS), but survival with UVC was 80.7% versus 90.1% without UVC (p = 0.012). Analysis of risk factors associated with death during umbilical catheterization reaffirmed that death remained significantly dependent upon UVC placement (OR = 35.7; 95% CI: 3.7-347.3, p = 0.002).
  
  
  CONCLUSIONS
  Successful umbilical catheterization of extremely premature newborns does not provide benefit through promotion of survival or reduction of morbidities when compared to others who are not successfully catheterized at the umbilicus.
authors.affiliation: Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA Children's Hospital of The King's Daughters, Norfolk, VA, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Oelberg
authors.affiliation: Children's Hospital of The King's Daughters, Norfolk, VA, USA.
authors.forename: Ashlynn
authors.initials: A
authors.lastname: Baker
authors.affiliation: Children's Hospital of The King's Daughters, Norfolk, VA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Quast
authors.affiliation: Children's Hospital of The King's Daughters, Norfolk, VA, USA.
authors.forename: Leslie
authors.initials: L
authors.lastname: Worley
mesh_terms: D001784:Blood Gas Analysis; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D004374:Ductus Arteriosus, Patent / Q000209:etiology / Q000401:mortality; D020345:Enterocolitis, Necrotizing / Q000209:etiology / Q000401:mortality; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007969:Leukomalacia, Periventricular / Q000209:etiology / Q000401:mortality; D008171:Lung Diseases / Q000209:etiology / Q000401:mortality; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D011795:Surveys and Questionnaires; D014471:Umbilical Veins
keywords: Umbilical venous catheter; high-risk newborns; umbilical arterial catheter