1371 Complications Associated with Insertion of Percutaneous Central Venous Lines

Objective: To analyse the complications involved in insertion of central venous lines (CVL). To determine the association of Coagulase negative staphylococcal (CONS) sepsis with CVL duration. Method: Prospective study of percutaneous CVL insertions over a 4 month period (Aug‘2009-Nov’ 2009) in Nottingham City Hospital (a UK Level 3 non-surgical Neonatal intensive care unit). Data were collected from the notes of those babies in whom a percutaneous CVL was inserted. Results: Twenty seven babies (23-40 weeks gestation, median 32 wks) had 36 percutaneous central venous lines inserted during the study period. The indications were predominantly for administering parental nutrition and/or for inotropes. 35 (97%) of insertions were completely documented in notes using a proforma. Twelve (33%) of the line insertions were associated with complications such as blockage (5), extravasations (2), coiled (2) and CONS sepsis (3). Complications were more common using 1 French lines (10/26) compared to 2 French lines (2/10). Median duration of line placement was 6 days, ranging from 1 to 32 days. Three babies (11%) became unwell with CONS sepsis confirmed by blood cultures, two of these having had the line in for more than 14 days. In all three occasions the line was removed and the baby treated successfully with antibiotics. Conclusion: This study showed a high incidence of percutaneous CVL complications (33%), less frequent when using 2 French lines. Strict aseptic precautions should be adhered to during line insertions and line removal should be considered if sepsis is suspected.