Utilization of Central Lines in Canadian Neonatal Intensive Care Units
CPS ePoster Library. Esmaeilizand R. Jun 25, 2015; 99128; 65
Dr. Rana Esmaeilizand
Dr. Rana Esmaeilizand
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Abstract
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Background
Central venous and arterial lines are commonly used in NICUs to provide nutrition and medications and for monitoring of blood pressure; however they have the potential to contribute to serious complications. Knowledge of current practice is limited and larger cohort studies are warranted.

Objective
To determine the trend and pattern of central line use for the period between 2005 and 2013 and identify variation amongst Canadian NICUs

Design/Methods
A retrospective cohort study of neonates < 30 weeks gestational age (GA) admitted between 2005 and 2013 was conducted using data from the Canadian Neonatal Network. Data on the use of central venous lines (CVLs) over 3 time periods (2005-2007, 2008-2010 and 2011-2013) while data on central arterial catheters (UACs) from 2010 to 2013 were examined. Baseline demographics and morbidities were compared between infants who had a central line and those who did not.

Results
20792 infants < 30 weeks were admitted during the study period. The use of central venous lines (CVL) increased since 2005-2007 for all GAs. This was due to an increase in UVC and PICC lines while the use of surgical CVLs decreased over time. CVL use varied significantly between units [AOR (95% CI) range: 0.10(0.05, 0.19) to 4.87 (2.35, 10.11)]. Infants who received CVLs had a significantly lower BW, GA and higher SNAP II scores than those who did not. SGA and surfactant use were more common in the CVL group. Multivariable analyses adjusting for GA, SNAP II and surfactant use showed that IVH ≥ grade 3, NEC, late onset sepsis and mortality were higher in the infants with CVLs (p <0.0001). There was a decrease in UAC use from 2010 to 2013 (p = 0.002).

Conclusions
CVL use in infants<30 weeks increased over the time period of this study in Canadian NICUs while UAC use decreased. The risk of mortality and major morbidities were increased among those who received CVLs. Further studies are warranted to develop standardized guidelines for central line insertion.
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