Complications of Central Venous Catheters in Neonates: A Comprehensive Level III Neonatal Intensive Care Unit Analysis

Background: To evaluate the use of central venous catheters (CVC), the incidence of related complications, to identify risk factors for these complications and their impact in a level III Neonatal Intensive Care Unit (NICU). Methods:A retrospective cohort study at Centro Hospitalar Universitrio de So Joo, Portugal, included neonates who underwent CVC placement from January 1, 2021, to December 31, 2022.Patient's demographics, CVC's characteristics, complications, and outcomes were collected.Statistical methods were used to assess CVC utilization rates, complication rates, associated risk factors and consequences.Results: Out of 677 admissions, 288 neonates met the study criteria.A total of 463 CVCs were placed, resulting in a utilization ratio of 59.3%.CVCs' complications occurred in 24.3% of neonates, corresponding to a complication rate of 22.9 per 1000 catheter days.Mechanical complications were the most common, followed by infectious and thrombotic events.Risk factors significantly associated with complications included inborn status and the cumulative number of CVCs.PICCs, in particular, had higher complication rates: infectious complications increased significantly after 14 days of placement, while mechanical complications were most prevalent within the first 4 days.CVC-related complications significantly impacted hospital length of stay and mortality.Conclusions: Strategies to minimize CVC's complications should focus on reducing the number of CVCs per patient, and improving insertion and maintenance techniques.PICCs, while beneficial, were associated with a higher risk of complications, suggesting a need for careful consideration of their use.Further research is required to refine guidelines for CVC management and enhance neonatal outcomes.