title: Incorrect umbilical vein catheterization is associated with severe periventricular hemorrhages and mortality in extremely premature newborns.
abstract: OBJECTIVE
  To investigate the relationship between umbilical vein catheter (UVC) placement and death in extremely premature newborns (<29 weeks gestation).
  
  
  METHODS
  Utilizing a retrospective, case-control study design, results for newborns that received UVC placements and died were compared with those who received UVC placements and survived (n = 719) by univariate and multiple logistic regression analyses.
  
  
  RESULTS
  Death rate was 30% in infants with low lines versus 16% in those without (p = 0.012). High UVC tip placement significantly and independently increased severe periventricular hemorrhages (p = 0.014). Severe periventricular hemorrhage increased death rates by 3-fold independent of gestational age (p <  0.001). Proper line placement significantly reduced severe periventricular hemorrhage by 2.5-fold independent of gestational age (p = 0.019).
  
  
  CONCLUSIONS
  In extremely premature newborns, incorrect UVC placement is significantly associated with death through its relation to severe periventricular hemorrhage.
authors.affiliation: Children's Hospital of The King's Daughters, Norfolk, VA, USA.|Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Waleed
authors.initials: W
authors.lastname: Kurtom
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
authors.affiliation: Children's Hospital of The King's Daughters, Norfolk, VA, USA.|Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Oelberg
mesh_terms: D055499:Catheter-Related Infections / Q000209:etiology / Q000401:mortality*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D002983:Clinical Competence; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D018805:Sepsis / Q000209:etiology / Q000401:mortality*; D014471:Umbilical Veins
keywords: Umbilical catheters; high-risk newborns; intraventricular hemorrhages