Children’s Hospital of The King’s Daughters, Norfolk, VA, USA
Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
Address for correspondence: 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; [email protected]
Abstract: 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.