Patrick D Carroll1, M Bridget Zimmerman2, Demet Nalbant3, Earl L Gingerich3, Guohua An4, Gretchen A Cress3, Peter Veng-Pedersen4, John A Widness5. 1. Women and Newborn Clinical Program, Intermountain Healthcare, Dixie Regional Medical Center, St. George, Utah, USA. 2. Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, Iowa, USA. 3. Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA. 4. Department of Pharmaceutical Sciences and Experimental Therapeutics, University of Iowa College of Pharmacy, Iowa City, Iowa, USA. 5. Stead Family Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA, john-widness@uiowa.edu.
Abstract
BACKGROUND: Umbilical arterial catheters (UACs) are frequently used in critically ill neonates. UAC are convenient, reliable, and allow for caregiver convenience in performing painless arterial blood sampling. We hypothesized that UAC removal in extremely low birth weight (ELBW) neonates will result in significantly less phlebotomy blood loss (PBL) after correcting for severity of illness. STUDY DESIGN AND METHODS: PBL was measured at a single center in 99 ELBW infants who survived to day 28. Individual infant's paired daily PBL for the two 24-h periods before and after UAC removal were compared using the paired t test. Daily PBL up to 7 days before and 7 days after UAC removal were compared using a logistic regression with mixed model analysis for repeated measures. Cumulative 28-day phlebotomy loss was evaluated by multiple linear regression analysis. RESULTS: PBL 24 h before and after UAC removal were 1.7 mL (95% CI 1.5-1.9) and 0.9 mL (95% CI 0.8-1.0; p < 0.0001), respectively. Cumulative 28-day PBL increased by 2.2 mL (±0.7) per day that a UAC was present with or without correction for severity of illness (p < 0.001). CONCLUSION: UAC removal is independently associated with a marked decline in PBL. We speculate the ease and convenience of UAC blood sampling lead to more frequent blood testing and greater PBL.
BACKGROUND: Umbilical arterial catheters (UACs) are frequently used in critically ill neonates. UAC are convenient, reliable, and allow for caregiver convenience in performing painless arterial blood sampling. We hypothesized that UAC removal in extremely low birth weight (ELBW) neonates will result in significantly less phlebotomy blood loss (PBL) after correcting for severity of illness. STUDY DESIGN AND METHODS: PBL was measured at a single center in 99 ELBW infants who survived to day 28. Individual infant's paired daily PBL for the two 24-h periods before and after UAC removal were compared using the paired t test. Daily PBL up to 7 days before and 7 days after UAC removal were compared using a logistic regression with mixed model analysis for repeated measures. Cumulative 28-day phlebotomy loss was evaluated by multiple linear regression analysis. RESULTS: PBL 24 h before and after UAC removal were 1.7 mL (95% CI 1.5-1.9) and 0.9 mL (95% CI 0.8-1.0; p < 0.0001), respectively. Cumulative 28-day PBL increased by 2.2 mL (±0.7) per day that a UAC was present with or without correction for severity of illness (p < 0.001). CONCLUSION:UAC removal is independently associated with a marked decline in PBL. We speculate the ease and convenience of UAC blood sampling lead to more frequent blood testing and greater PBL.
Authors: Amélia Miyashiro Nunes dos Santos; Ruth Guinsburg; Maria Fernanda Branco de Almeida; Renato S Procianoy; Cléa Rodrigues Leone; Sérgio Tadeu Martins Marba; Ligia Maria Suppo de Souza Rugolo; Humberto Holmer Fiori; José Maria de Andrade Lopes; Francisco Eulógio Martinez Journal: J Pediatr Date: 2011-04-13 Impact factor: 4.406
Authors: Demet Nalbant; Prasad Bhandary; Nell I Matthews; Robert L Schmidt; Anna Bogusiewicz; Gretchen A Cress; M Bridget Zimmerman; Ronald G Strauss; Donald M Mock; John A Widness Journal: Pediatr Res Date: 2013-09-03 Impact factor: 3.756