Umbilical venous catheterizations: audit by the Study Group for Complications of Perinatal Care.

The Study Group for Complications of Perinatal Care, through 13 of its participating neonatal intensive care units, conducted a prospective audit to describe contemporary use of umbilical venous catheters (UVCs) over 3 months in 1951 admissions. Frequency of UVC attempts was 15.5% for all patients and greatest (50%) in patients of 1000 g or less birthweight (BW), with a wide range of frequency by institution and by BW grouping. Institutions with more 1500 g or less BW infants tended to use UVCs more frequently. The most common reason for placement was general intravascular access. A variety of fluids were infused, and in most cases heparin was employed. Mean duration of use was 4.4 days for all patients and longest (5.5 days) in infants in the 1001 to 1500 g BW group. The most common reason for UVC removal was lack of further need. UVCs appear to be used more commonly and for a longer duration than is currently recommended. There is a need for a prospective, randomized trial to assess the risks properly and maximize the benefits of UVC usage.