Routine surveillance ultrasound for the management of central venous catheters in neonates.

OBJECTIVES: To evaluate the frequency of central venous catheter (CVC)-related thrombi detected by routine surveillance ultrasound, and to assess whether positive findings had an impact on management or outcomes. STUDY DESIGN: All neonates in a tertiary neonatal intensive care unit who had a CVC inserted for >14 days underwent routine surveillance ultrasound biweekly between January 2003 and December 2009. Data were reviewed retrospectively. RESULTS: Although all neonates were asymptomatic at time of surveillance ultrasound, 645 of the total 1333 CVCs inserted in 1012 neonates underwent surveillance ultrasound, and thrombi were detected in 69 (10.7%). The CVCs with thrombi were more likely to be removed for nonelective reasons compared with CVCs without thrombi (59% vs 38%; P = .001; OR, 2.4, 95% CI 1.4-3.9). A total of 955 surveillance ultrasounds were performed to detect and monitor 69 CVCs with thrombi. The majority of thrombi were nonocclusive and nonprogressive. A change in management occurred in 8 cases of CVC-related thrombi (12%), or 1% of all screened cases. An average of 14 ultrasounds were required to detect and monitor 1 CVC with thrombus, at a cost of $951 per CVC with thrombus and $8106 per case of CVC-related thrombi with a change in treatment. CONCLUSION: Asymptomatic thrombi were detected in a significant proportion of CVCs by routine surveillance ultrasound. There were significant costs, but infrequent changes to patient management.

Short-term outcome of very low birth weight infants in a developing country: comparison with the Vermont Oxford Network.

OBJECTIVES: To determine the outcome of very low birth weight infants (VLBWI) admitted to a level III NICU in UAE and compare the results to percentiles published by the Vermont Oxford Network (VON). METHOD: Outcome data were collected retrospectively, using standard definitions, on a cohort of VLBWI 500-1500 g admitted between January 2004 and December 2006. RESULTS: Of the 173 infants weighing 501-1500 g at birth, 85.6% survived until discharge, which corresponds to the 50th percentile (P50) of VON. Chronic lung disease (CLD) occurred in 12.1% (