{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:29:07Z","timestamp":1793230147340,"version":"4.5.0"},"reference-count":40,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2006,7,1]]},"abstract":"<jats:p>BACKGROUND. Umbilical vein and percutaneous central venous catheters are often used in preterm infants, but they can lead to complications, including infection.<\/jats:p><jats:p>OBJECTIVE. We hypothesized that long-term umbilical vein catheter use would result in fewer infections than short-term umbilical vein catheter use followed by percutaneous central venous catheter placement.<\/jats:p><jats:p>DESIGN\/METHODS. Infants \u22641250 g with umbilical vein catheters placed at admission were randomly assigned to a long-term (umbilical vein catheter up to 28 days) or short-term (umbilical vein catheter for 7\u201310 days followed by percutaneous central venous catheter) group. Catheter infection was defined as symptoms and \u22651 positive blood culture for definite pathogens or &amp;gt;1 positive culture for other organisms, with a catheter in place. Clinically significant echocardiogram findings were defined as thrombi threatening vascular occlusion, crossing\/blocking heart valves, or otherwise felt to be significant by the cardiologist. The primary outcome was time from birth to catheter infection, analyzed by the log-rank test.<\/jats:p><jats:p>RESULTS. There were 106 subjects in the short-term group and 104 in the long-term group with birth weights of 915 \u00b1 198 and 931 \u00b1 193 g and gestational ages of 27.8 \u00b1 2.0 and 27.7 \u00b1 2.2 weeks, respectively. The distribution of time to catheter infection did not differ between the groups. The overall incidence of catheter infection was 13% in the short-term group and 20% in the long-term group. Median age at catheter infection was 11.5 days in the short-term group and 14 days in the long-term group. There were 7.4 infections per 1000 catheter-days in the short-term group and 11.5 per 1000 in the long-term group. Seven infections in the short-term group were in umbilical vein catheters, and 18 infections in the long-term group were in umbilical vein catheter. Echocardiograms detected 4 infants in the short-term group and 7 infants in the long-term group with significant thrombosis. All significant thrombi were at the site of the umbilical vein catheter tip. No thrombus caused hemodynamic compromise, no child had clinical symptoms of thrombosis, and none required therapy. Of the 45 small-for-gestational-age infants in the study, 9 developed thrombi (short-term group, 4; long-term group, 5). The incidence of thrombi was higher in the small-for-gestational-age group (20%) versus other study subjects (9%). There were no differences in time to full feedings or to regain birth weight or in the incidence of necrotizing enterocolitis or death.<\/jats:p><jats:p>CONCLUSIONS. Infection and complication rates were similar between infants managed with an umbilical vein catheter in place for up to 28 days compared with infants managed with an umbilical vein catheter replaced by a percutaneous central venous catheter after 7 to 10 days. Umbilical vein catheter durations beyond the current Centers for Disease Control and Prevention\u2013recommended limit of 14 days may be reasonable.<\/jats:p>","DOI":"10.1542\/peds.2005-1880","type":"journal-article","created":{"date-parts":[[2006,6,20]],"date-time":"2006-06-20T00:51:35Z","timestamp":1150764695000},"page":"e25-e35","source":"Crossref","is-referenced-by-count":125,"title":["A Randomized Trial Comparing Long-term and Short-term Use of Umbilical Venous Catheters in Premature Infants With Birth Weights of Less Than 1251 Grams"],"prefix":"10.1542","volume":"118","author":[{"given":"Meggan","family":"Butler-O\u2019Hara","sequence":"first","affiliation":[{"name":"Strong Children\u2019s Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol J.","family":"Buzzard","sequence":"additional","affiliation":[{"name":"Strong Children\u2019s Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Reubens","sequence":"additional","affiliation":[{"name":"Strong Children\u2019s Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"McDermott","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"DiGrazio","sequence":"additional","affiliation":[{"name":"General Clinical Research Center, University of Rochester School of Medicine and Dentistry, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl T.","family":"D\u2019Angio","sequence":"additional","affiliation":[{"name":"Strong Children\u2019s Research Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2006,7,1]]},"reference":[{"key":"2021120823094316000_R1","doi-asserted-by":"crossref","unstructured":"Scott JM. Iatrogenic lesions in babies following umbilical vein catheterization. Arch Dis Child.\u20081965;40:426\u2013429","DOI":"10.1136\/adc.40.212.426"},{"key":"2021120823094316000_R2","doi-asserted-by":"crossref","unstructured":"Kitterman JA, Phibbs RH, Tooley WH. Catheterization of umbilical vessels in newborn infants. Pediatr Clin North Am.\u20081970;17:895\u2013912","DOI":"10.1016\/S0031-3955(16)32486-5"},{"key":"2021120823094316000_R3","doi-asserted-by":"crossref","unstructured":"Johns AW, Kitchen WH, Leslie DW. Complications of umbilical vessel catheters. Med J Aust.\u20081972;2(15):810\u2013815","DOI":"10.5694\/j.1326-5377.1972.tb103561.x"},{"key":"2021120823094316000_R4","doi-asserted-by":"crossref","unstructured":"Junker P, Egeblad M, Nielsen O, Kamper J. Umbilical vein catheterization and portal hypertension. 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J Perinatol.\u20081996;16:461\u2013466"},{"key":"2021120823094316000_R15","doi-asserted-by":"crossref","unstructured":"Landers S, Moise AA, Fraley JK, Smith EO, Baker CJ. Factors associated with umbilical catheter-related sepsis in neonates. Am J Dis Child.\u20081991;145:675\u2013680","DOI":"10.1001\/archpedi.1991.02160060093028"},{"key":"2021120823094316000_R16","doi-asserted-by":"crossref","unstructured":"Camara D. Minimizing risks associated with peripherally inserted central catheters in the NICU. MCN Am J Matern Child Nurs.\u20082001;26;17\u201321","DOI":"10.1097\/00005721-200101000-00005"},{"key":"2021120823094316000_R17","doi-asserted-by":"crossref","unstructured":"O\u2019Grady NP, Alexander M, Dellinger EP, et al. Guidelines for the prevention of intravascular catheter\u2013related infections. The Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention, U.S. Pediatrics.\u20082002;110(5). 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