Variables Associated With Central Venous Catheter Occlusions in 2 Pediatric ICUs With Differing Maintenance Protocols

BACKGROUND: There is a lack of standardization in the maintenance of central venous catheters (CVCs) within the critically ill infant population, and CVCs have risks, including occlusions. OBJECTIVES: The purpose of this retrospective research study was to compare outcomes for infants aged 37 weeks postmenstrual age (PMA) to 6 months with CVCs managed in 2 intensive care units (ICUs) with 2 different maintenance protocols. METHODS: Infants with postmenstrual ages (PMA) ranging from 37 weeks to 6 months who had CVCs sized 1.1 to 3 Fr, inserted between April 2017 and December 2021, were included. Data were extracted manually and electronically. Descriptive and regression analyses were conducted. RESULTS: There were a total of 717 subjects and 878 CVCs in the sample. Infants in ICU 1 were slightly older (median age 18 vs. 7 d), weighed less (median 2.8 vs. 3.5 kg), and had fewer CVC line days (median 15 vs. 20 d). There were 135 occlusions (15.4%), with a 10.8% occlusion rate in ICU 1 and a 33.1% occlusion rate in ICU 2. Unit location (0.024), CVC line days (<0.001), and size of the CVC (0.015) were associated with occlusions (univariate P<.20) and were included in the multivariate model. CVC line days were found to be a risk factor of occlusion (OR=1.08, 95% CI=[1.04, 1.12], P<.001) after controlling for ethnicity and variables univariately associated with occlusion. DISCUSSION: As CVCs are left in place, the likelihood of experiencing an occlusion increases. These results support prior studies that show CVCs often can fail before completion of intended therapy and underscore the need for maintenance protocols that reduce occlusion rates.