Adverse Events with Silver-impregnated Versus Conventional Polyurethane Umbilical Venous Catheters in Very Preterm Neonates: A Retrospective Cohort Study

Abstract

Introduction

Materials used for the production of umbilical vein cannulation (UVC) need to satisfy essential requirements of pliability, tensile strength and kink resistance to ensure safe insertion/maintenance. This study compared adverse events with two catheter materials, silver-impregnated catheter (SIC) and conventional polyurethane catheter (CC).

Methods

This retrospective study included neonates ≤30 weeks’ gestation who had UVC. Two time epochs were compared: when SICs were used versus when CCs were used. Removal of UVC for adverse events (defined as inappropriate positions, mechanical events, inadvertent exteriorisation) was recorded. Catheter-associated infection was studied as a secondary outcome.

Results

Sixty neonates were included in each group. Adverse events were significantly more when SICs were used (21.6% vs. 2 (3.3%); OR 8.0 (1.6,75.5); P = .002). Catheter-associated infections were not different between groups; the study, however, was not powered to find a difference in this outcome.

Conclusions

Adverse events, possibly due to material properties, were more when SIC were used for UVC in very preterm neonates. This is a hypothesis-generating retrospective study; larger prospective studies that consider confounders like catheter sizes and neonatal illness severity are required. It may, however, be prudent for centres where catheter-related infections are less to use CCs in small neonates.