Peripheral Insertion of Central Catheters in Newborns

Abstract

Objective: To describe the effects of a management protocol for the peripheral insertion of central catheters in newborns, specifically the frequency of infection, phlebitis, coagulation alterations and catheter-related mechanical complications at the Neonatal Intensive Care Unit at the Bolivariana University Clinic.

Method: This is a quantitative study of a descriptive nature. Fifty (50) newborns were selected through non-probability sampling. Neonates with catheters inserted in other neonatal units and with a body weight less than 800 g were excluded for reasons associated with minimal manipulation, as were neonates with blood coagulation alterations, and those that received heparin by other means. The catheters were inserted at any gestational age, in neonates with a body weight of more than 800 grams, and 24 hours after birth. The study used a form that was applied by the researchers and by the nurses in the unit. Epi-info 2005 was employed to analyze the data.

Results: The main reason for removal of the catheter was termination of treatment (70%). Other motives, in order of importance, were the appearance of phlebitis (8%) and suspicious infection (6%). The proportion of catheter obstruction was 4%. The central catheter points came to 68%, and the non-central points, 32%. The partial thromboplastin time test, after a heparin infusion of 0.5 IU/ml/h, was 94% normal.

Conclusion: The usual protocol will have to be updated and changes made with respect to directions for insertion and how often x-rays should be taken, in addition to emphasizing the importance of nursing care to prevent complications such as infection, phlebitis, obstruction and displacement.