Adverse Events with Silver-impregnated Versus Conventional Polyurethane Umbilical Venous Catheters in Very Preterm Neonates: A Retrospective Cohort Study

Introduction Materials used for the production of umbilical vein cannulation (UVC) need to satisfy essential requirements of pliability, tensile strength and kink resistance to ensure safe insertion/maintenance. This study compared adverse events with two catheter materials, silver-impregnated catheter (SIC) and conventional polyurethane catheter (CC). Methods This retrospective study included neonates ≤30 weeks’ gestation who had UVC. Two time epochs were compared: when SICs were used versus when CCs were used. Removal of UVC for adverse events (defined as inappropriate positions, mechanical events, inadvertent exteriorisation) was recorded. Catheter-associated infection was studied as a secondary outcome. Results Sixty neonates were included in each group. Adverse events were significantly more when SICs were used (21.6% vs. 2 (3.3%); OR 8.0 (1.6,75.5); P = .002). Catheter-associated infections were not different between groups; the study, however, was not powered to find a difference in this outcome. Conclusions Adverse events, possibly due to material properties, were more when SIC were used for UVC in very preterm neonates. This is a hypothesis-generating retrospective study; larger prospective studies that consider confounders like catheter sizes and neonatal illness severity are required. It may, however, be prudent for centres where catheter-related infections are less to use CCs in small neonates.