Incorrect umbilical vein catheterization is associated with severe periventricular hemorrhages and mortality in extremely premature newborns

OBJECTIVE:

To investigate the relationship between umbilical vein catheter (UVC) placement and death in extremely premature newborns (<29 weeks gestation).

STUDY DESIGN:

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.

RESULT:

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).

CONCLUSION:

In extremely premature newborns, incorrect UVC placement is significantly associated with death through its relation to severe periventricular hemorrhage.

*Corresponding Author: 

Waleed Kurtom, MD, Children’s Hospital of The King’s Daughters, Norfolk, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA. Tel.: +1 757 668 9763; Fax: +1 757 668 9766; waleed.kurtom@chkd.org.