title: [Catheter tip position and risk of mechanical complications in a neonatal unit].
abstract: BACKGROUND
  The use of central catheters (CC) is associated with mechanical complications (MC).
  
  
  OBJECTIVE
  Our objetive was to determine the relationship between CC positions and associated MC in neonates.
  
  
  METHODS
  A descriptive analytical study was performed over a six year period in the NICU of the University Hospital Santa Lucía de Cartagena. Details were collected on the CC used, indication, reason for withdrawal, position in the imaging, MC, and treatment arising from them, as well as epidemiological data.
  
  
  RESULTS
  Of the total of 604 CC studied, the majority (347) were via the umbilical vein, followed by epicutaneous (193), and femoral vein (34). There were MC in 14.2% of catheters. Incorrect position of the tip was associated with greater MC (21.1 vs 8.2%; P<.001), including withdrawal due to MC (8.4 vs 3.1%; P<.01), extravasation (4.9 vs 1.9%; P<.05), pleural and pericardial effusions (1.4 vs 0.0%; P<.05), liver haematomas (4.6 vs 0.6%; P<.01), and ascites (2.8 vs 0.0%; P<.01). The midclavicular epicutaneous position of the tip was associated with greater MC (18.5 vs 6.8%; P<.05) than the brachiocephalic (0 vs 6.8%;NS). The low and ductal position of the umbilical vein catheter was also associated with higher rates of MC (24.5 vs 6%; P<.001 and 27 vs 6%; P<.001) due to the position of the tip. The most common complication was accidentally dislodged catheter.
  
  
  CONCLUSIONS
  The incorrect location of the tip was associated with more MC. The midclavicular epicutaneous had more risk than centrally or brachiocephalic locations. The low and ductal positions of the umbilical vein catheter were associated with higher rates of MC.
authors.affiliation: Unidad de Neonatología y UCI Neonatal, Hospital Universitario Santa Lucía, Complejo Hospitalario Universitario de Cartagena, Cartagena, Murcia, España. Electronic address: jmlloreda@gmail.com.
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Lloreda-García
authors.affiliation: Unidad de Neonatología y UCI Neonatal, Hospital Universitario Santa Lucía, Complejo Hospitalario Universitario de Cartagena, Cartagena, Murcia, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Lorente-Nicolás
authors.affiliation: Unidad de Neonatología y UCI Neonatal, Hospital Universitario Santa Lucía, Complejo Hospitalario Universitario de Cartagena, Cartagena, Murcia, España.
authors.forename: Francisca
authors.initials: F
authors.lastname: Bermejo-Costa
authors.affiliation: Unidad de Neonatología y UCI Neonatal, Hospital Universitario Santa Lucía, Complejo Hospitalario Universitario de Cartagena, Cartagena, Murcia, España.
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Fernández-Fructuoso
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: Catheter tip position; Catéteres centrales; Catéterización vena umbilical; Central catheters; Complicaciones; Complications; Epicutáneos; Localización punta catéteres; Tras catheter positio; Umbilical vein catheterisation