الفهرس 
Central LinesOnly 14 pages are availabe for public view
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Abstract
Insertion of central venous catheter is an essential procedure in anesthesia and ICU. It is used for hemodynamic monitoring and administration of nutrition, drugs and fluids. It is associated with many complications including arterial puncture, hematoma formation, pneumothorax, hemothorax, and malpositioning, failure of insertion, loss of guide wire, chylothorax and chylopericardium.
The purpose of this study was to review the data concerning indications, methods of insertion and maintenance related to central lines in neonates in order to provide recommendations for clinical practice. Special attention was given to the topic of catheter related complications.
This study was conducted as retrospective study in neonatal intensive care unit of Almaza Neonatal Hospital, Cairo, Egypt. All files of patients attending the NICU in the period between January 2011 and December 2013 were reviewed to collect the required data. Three hundred and seventy (370) completed files were presented.
Gestational Age of the enrolled neonates ranged between 28-41 weeks with mean±SD of 34.41±2.867 wks, weight ranged between 900-4720 gm with mean±SD of 2013.53±715.288 gm. Regarding gender; 193 (52.2%) males and 177 (47.8%) females were included.
Central line was inserted in 133 neonates (35.9%) due to difficult cannulation, 207 neonates (55.9%) were expected to have prolonged hospitalization so a central line was inserted for medication and IV fluids administration and 30 neonates (8.1%) needed a central line for exchange transfusion. According to site of central line tip, 58 (15.7%) were in SVC, 172 (46.5%) were between SVC and right atrium, 83 (22.4%) were in right atrium and 57 (15.4%) were in IVC.
The cause of central line removal, 230 (62.2%) improved, 44 (11.9%) died, 49 (13.2%) accidental removal, 31 (8.4%) blockage and 16 (4.3%) due to local edema.
Duration of central line insertion ranged between 1-57 days, with mean±SD of 18.94±9.462 days.
Results of the current study show that the different complications that occurred to neonates while central lines were inserted, 189 (51.1%) did not experience any complications, 109 (29.5%) had sepsis, 22 (5.9%) had inflamed insertion site, 40 (10.8%) experienced leakage, 6 (1.6%) had pericardial effusion and 4 (1.1%) had pneumothorax.
Two hundred and forty four (65.9%) neonate had no growth on culture of tip of central line, 60 (16.2%) had a growth of E-coli, 45 (12.2%) had Staph aurious, 8 (2.2%0 had growth of Staph epidermidis, 4 (1.1%) had a growth of pseudomonas and 9 (2.4%) had a growth of candida albicans.
Results of the current study show that neonates < 1500 experience significantly higher complications compared to neonates ≥ 1500 gm. Highly significant higher no growth in neonates with weight ≥ 1500 gm compared to neonates < 1500.