Central lines in a tertiary NICU its Indication & outcome – A descriptive study

Abstract

Introduction: Vascular access especially in critically ill and preterm neonates is a major life saving procedure. There is a need for a sustained access for medications and providing the essential nutrition in sick babies. Various techniques and sites are used for IV lines in the intensive care. There are also some known and associated complications with central lines.

Objectives: To describe the indications for insertion, indication for removal, type of central line and outcome of central lines placed in neonates.

Methodology: This is an audit of central lines inserted in a tertiary care neonatal ICU between January 2016 to December 2016.

Results: A total of 284 central lines either as umbilical, central or PICC lines were inserted. 63% of the lines were inserted through the umbilical vein and 21% through the femoral route mostly in surgical neonates. The most common central line inserted was the umbilical catheter (66%). The medical team inserted 73% of the lines while the remaining 27% was by the surgical team. Central lines in our unit were associated with minimal complications with only 3 babies posing with prolonged bleeding from insertion site. The most common indication for insertion was for infusion of multiple medications (62.7%) and inotropes (9.9) %. Majority of the lines were removed when the indication for use ceased (66.2%).

Conclusion: Umbilical line is the most common central line inserted in neonates followed by surgical long lines. Indications for use can be varied and complications are minimal if proper technique and care is followed.