{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:55:18Z","timestamp":1774425318125,"version":"3.50.1"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"14","funder":[{"name":"Children's Hospital's Neonatal Consortium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>\n            Objective\u2003Infants with congenital diaphragmatic hernia (CDH) require multiple invasive interventions carrying inherent risks, including central venous and arterial line placement. We hypothesized that specific clinical or catheter characteristics are associated with higher risk of nonelective removal (NER) due to complications and may be amenable to efforts to reduce patient harm.<\/jats:p><jats:p>\n            Study Design\u2003Infants with CDH were identified in the Children's Hospital's Neonatal Database (CHND) from 2010 to 2016. Central line use, duration, and complications resulting in NER are described and analyzed by extracorporeal membrane oxygenation (ECMO) use.<\/jats:p><jats:p>\n            Results\u2003A total of 1,106 CDH infants were included; nearly all (98%) had a central line placed, (average of three central lines) with a total dwell time of 22 days (interquartile range [IQR]: 14\u201339). Umbilical arterial and venous lines were most common, followed by extremity peripherally inserted central catheters (PICCs); 12% (361\/3,027 central lines) were removed secondary to complications. Malposition was the most frequent indication for NER and was twice as likely in infants with intrathoracic liver position. One quarter of central lines in those receiving ECMO was placed while receiving this therapy.<\/jats:p><jats:p>\n            Conclusion\u2003Central lines are an important component of intensive care for infants with CDH. Careful selection of line type and location and understanding of common complications may attenuate the need for early removal and reduce risk of infection, obstruction, and malposition in this high-risk group of patients.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0041-1722941","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:39:04Z","timestamp":1612399144000},"page":"1524-1532","source":"Crossref","is-referenced-by-count":5,"title":["Central Line Utilization and Complications in Infants with Congenital Diaphragmatic Hernia"],"prefix":"10.1055","volume":"29","author":[{"given":"Theresa R.","family":"Grover","sequence":"additional","affiliation":[{"name":"Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-8376","authenticated-orcid":false,"given":"Mark F.","family":"Weems","sequence":"additional","affiliation":[{"name":"Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly","family":"Brozanski","sequence":"additional","affiliation":[{"name":"St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Daniel","sequence":"additional","affiliation":[{"name":"Children's Mercy Hospitals & Clinics, University of Missouri, Kansas City, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth","family":"Haberman","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Rintoul","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Walden","sequence":"additional","affiliation":[{"name":"Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holly","family":"Hedrick","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burhan","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Seabrook","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karna","family":"Murthy","sequence":"additional","affiliation":[{"name":"Ann and Robert H. Lurie Children's Hospital, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Zaniletti","sequence":"additional","affiliation":[{"name":"Children's Hospital Association, Inc., Overland Park, Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Keene","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta at Egleston, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Children's Hospitals Neonatal Consortium (CHNC) Congenital Diaphragmatic Hernia Focus 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