Multicenter Study

. 2023 May;173(7-8):161-167.

doi: 10.1007/s10354-022-00952-z. Epub 2022 Aug 8.

Umbilical venous catheter- and peripherally inserted central catheter-associated complications in preterm infants with birth weight < 1250 g : Results from a survey in Austria and Germany

Steffi Hess¹, Martin Poryo², Ralf Böttger³, Axel Franz⁴, Daniel Klotz⁵, Knud Linnemann⁶, Torsten Ott⁷, Johannes Pöschl⁸, Michael Schroth⁹, Anja Stein¹⁰, Elisabeth Ralser¹¹, Heiko Reutter¹², Ulrich H Thome¹³, Christian Wieg¹⁴, Anne Ehrlich¹⁵, Christian Ruckes¹⁵, Stefan Wagenpfeil¹⁶, Michael Zemlin¹, Cihan Papan¹⁷, Arne Simon¹⁸, Johannes Bay¹, Sascha Meyer¹⁹

Affiliations

¹ Department of General Pediatrics and Neonatology, Saarland University Medical Center, Kirrberger Str., Building 9, 66421, Homburg, Germany.
² Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany.
³ University Children's Hospital, Otto von Guericke University Magdeburg, Magdeburg, Germany.
⁴ University Children's Hospital, Eberhard Karls University Tübingen, Tübingen, Germany.
⁵ Department of Neonatology, Center for Pediatrics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ University Children's Hospital, Greifswald University Hospital, Greifswald, Germany.
⁷ University Children's Hospital, University Hospital Muenster, Münster, Germany.
⁸ University Children's Hospital, Heidelberg University Hospital, Heidelberg, Germany.
⁹ Children's Hospital Nürnberg, Nürnberg, Germany.
¹⁰ University Children's Hospital, Essen University Hospital, Essen, Germany.
¹¹ University Children's Hospital, Medical University of Innsbruck, Innsbruck, Austria.
¹² Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatric and Adolescent Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
¹³ University Children's Hospital, University of Leipzig Medical Center, Leipzig, Germany.
¹⁴ Children's Hospital Aschaffenburg, Aschaffenburg, Germany.
¹⁵ Interdisziplinäres Zentrum für Klinische Studien (IZKS), Johannes Gutenberg-Universität, Mainz, Germany.
¹⁶ Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar, Germany.
¹⁷ Department of Medical Microbiology and Hospital Hygiene, Saarland University Medical Center, Homburg, Germany.
¹⁸ Department of Pediatric Hematology and Oncology, Infectious Diseases, Saarland University Medical Center, Homburg, Germany.
¹⁹ Department of General Pediatrics and Neonatology, Saarland University Medical Center, Kirrberger Str., Building 9, 66421, Homburg, Germany. sascha.meyer@uks.eu.

PMID: 35939216
PMCID: PMC10147741
DOI: 10.1007/s10354-022-00952-z

Multicenter Study

Umbilical venous catheter- and peripherally inserted central catheter-associated complications in preterm infants with birth weight < 1250 g : Results from a survey in Austria and Germany

Steffi Hess et al. Wien Med Wochenschr. 2023 May.

. 2023 May;173(7-8):161-167.

doi: 10.1007/s10354-022-00952-z. Epub 2022 Aug 8.

Authors

Affiliations

¹ Department of General Pediatrics and Neonatology, Saarland University Medical Center, Kirrberger Str., Building 9, 66421, Homburg, Germany.
² Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany.
³ University Children's Hospital, Otto von Guericke University Magdeburg, Magdeburg, Germany.
⁴ University Children's Hospital, Eberhard Karls University Tübingen, Tübingen, Germany.
⁵ Department of Neonatology, Center for Pediatrics, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
⁶ University Children's Hospital, Greifswald University Hospital, Greifswald, Germany.
⁷ University Children's Hospital, University Hospital Muenster, Münster, Germany.
⁸ University Children's Hospital, Heidelberg University Hospital, Heidelberg, Germany.
⁹ Children's Hospital Nürnberg, Nürnberg, Germany.
¹⁰ University Children's Hospital, Essen University Hospital, Essen, Germany.
¹¹ University Children's Hospital, Medical University of Innsbruck, Innsbruck, Austria.
¹² Division of Neonatology and Pediatric Intensive Care Medicine, Department of Pediatric and Adolescent Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
¹³ University Children's Hospital, University of Leipzig Medical Center, Leipzig, Germany.
¹⁴ Children's Hospital Aschaffenburg, Aschaffenburg, Germany.
¹⁵ Interdisziplinäres Zentrum für Klinische Studien (IZKS), Johannes Gutenberg-Universität, Mainz, Germany.
¹⁶ Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, Homburg/Saar, Germany.
¹⁷ Department of Medical Microbiology and Hospital Hygiene, Saarland University Medical Center, Homburg, Germany.
¹⁸ Department of Pediatric Hematology and Oncology, Infectious Diseases, Saarland University Medical Center, Homburg, Germany.
¹⁹ Department of General Pediatrics and Neonatology, Saarland University Medical Center, Kirrberger Str., Building 9, 66421, Homburg, Germany. sascha.meyer@uks.eu.

PMID: 35939216
PMCID: PMC10147741
DOI: 10.1007/s10354-022-00952-z

Abstract
in English, German

Background and objective: Umbilical venous catheters (UVC) and peripherally inserted central catheters (PICC) are commonly used in preterm infants but have been associated with a number of serious complications. We performed a survey in Austria and Germany to assess the use of UVCs and PICCs in preterm infants with a birth weight < 1250 g and associated rates of catheter-related adverse events.

Methods: Electronic survey of participating centers of the NeoVitaA trial. Main outcome parameter was the reported rates of UVC- and PICC-associated complications (infection, thrombosis, emboli, organ injury, arrhythmia, dislocation, miscellaneous).

Results: In total, 20 neonatal intensive care units (NICU) providing maximal intensive care in Austria and Germany (level I) were contacted, with a senior neonatologist response rate of 12/20 (60%). The reported rates for UVC with a dwell time of 1-10 days were bacterial infection: 4.2 ± 3.4% (range 0-10%); thrombosis: 7.3 ± 7.1% (0-20%); emboli: 0.9 ± 2.0% (0-5%); organ injury: 1.1 ± 1.9% (0-5%); cardiac arrhythmia: 2.2 ± 2.5% (0-5%); and dislocation: 5.4 ± 8.7% (0-30%); and for PICCs with a dwell time of 1-14 days bacterial infection: 15.0 ± 3.4% (range 2.5-30%); thrombosis; 4.3 ± 3.5% (0-10%); emboli: 0.8 ± 1.6% (0-5%); organ injury: 1.5 ± 2.3% (0-5%); cardiac arrhythmia: 1.5 ± 2.3% (0-5%), and dislocation: 8.5 ± 4.6% (0-30%).

Conclusion: The catheter-related complication rates reported in this survey differed between UVCs and PICCs and were higher than those reported in the literature. To generate more reliable data on this clinically important issue, we plan to perform a large prospective multicenter randomized controlled trial investigating the non-inferiority of a prolonged UVC dwell time (up to 10 days) against the early change (up to 5 days) to a PICC.

Zusammenfassung: HINTERGRUND UND ZIEL: Nabelvenenkatheter („umbilical venous catheters“ [UVC]) und periphere zentrale Venenkatheter (PICC) werden häufig bei Frühgeborenen eingesetzt, sind jedoch mit einer Reihe von schwerwiegenden Komplikationen verbunden. In Österreich und Deutschland wurde eine Umfrage durchgeführt, um die Verwendung von UVC und PICC bei Frühgeborenen mit einem Geburtsgewicht < 1250 g und die damit verbundenen Raten von katheterbedingten unerwünschten Ereignissen zu bewerten.

Methoden: Elektronische Befragung der teilnehmenden Zentren der NeoVitaA-Studie. Hauptergebnisparameter waren die gemeldeten Raten von UVC- und PICC-assoziierten Komplikationen (Infektion, Thrombose, Embolie, Organverletzung, Arrhythmie, Dislokation, Sonstiges).

Ergebnisse: Insgesamt wurden 20 neonatale Intensivstationen (NICU) mit maximaler Intensivpflege in Österreich und Deutschland (Level I) kontaktiert, wobei 12/20 (60 %) von leitenden Neonatologen beantwortet wurden. Die gemeldeten Raten für UVC mit einer Verweildauer von 1 bis 10 Tagen waren bakterielle Infektionen: 4,2 ± 3,4 % (Bereich: 0–10 %); Thrombose: 7,3 ± 7,1 % (0–20 %); Embolie: 0,9 ± 2,0 % (0–5 %); Organverletzung: 1,1 ± 1,9 % (0–5 %); Herzrhythmusstörungen: 2,2 ± 2,5 % (0–5 %); und Dislokation: 5,4 ± 8,7% (0–30 %); und bei PICC mit einer Verweildauer von 1 bis 14 Tagen bakterielle Infektionen: 15,0 ± 3,4 % (Bereich: 2,5–30 %); Thrombose: 4,3 ± 3,5 % (0–10 %); Embolie: 0,8 ± 1,6 % (0–5 %); Organverletzung: 1,5 ± 2,3 % (0–5 %); Herzrhythmusstörungen: 1,5 ± 2,3 % (0–5 %) und Verrenkungen: 8,5 ± 4,6 % (0–30 %).

Schlussfolgerung: Die in dieser Umfrage berichteten katheterbedingten Komplikationsraten unterschieden sich zwischen UVC und PICC und waren höher als die in der Literatur berichteten. Um zuverlässigere Daten zu diesem klinisch wichtigen Thema zu erhalten, ist eine große prospektive, multizentrische, randomisierte, kontrollierte Studie geplant, in der die Nichtunterlegenheit einer verlängerten UVC-Verweildauer (bis zu 10 Tage) gegenüber dem frühen Wechsel (bis zu 5 Tage) zu einem PICC untersucht werden soll.

Keywords: Emboli; Infection; Organ injury; Peripherally inserted central catheter; Survey; Thrombosis; Umbilical venous catheter; Very low birth weight infants.

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Conflict of interest statement

S. Hess, M. Poryo, R. Böttger, A. Franz, D. Klotz, K. Linnemann, T. Ott, J. Pöschl, M. Schroth, A. Stein, E. Ralser, H. Reutter, U. H. Thome, C. Wieg, A. Ehrlich, C. Ruckes, S. Wagenpfeil,M. Zemlin, C. Papan, A. Simon, J. Bay, and S. Meyer declare that they have no competing interests.

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Umbilical venous catheter- and peripherally inserted central catheter-associated complications in preterm infants with birth weight < 1250 g : Results from a survey in Austria and Germany

Affiliations

Umbilical venous catheter- and peripherally inserted central catheter-associated complications in preterm infants with birth weight < 1250 g : Results from a survey in Austria and Germany

Authors

Affiliations

Abstract
in English, German

Conflict of interest statement

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Abstract in English, German

Conflict of interest statement

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Abstract
in English, German