Women and Newborn Clinical Program, Intermountain Healthcare, Dixie Regional Medical Center, St. George, Utah, USA.
Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
Neonatology. 2020;117(3):294-299. doi: 10.1159/000506907. Epub 2020 Jun 19.
Umbilical arterial catheters (UACs) are frequently used in critically ill neonates. UAC are convenient, reliable, and allow for caregiver convenience in performing painless arterial blood sampling. We hypothesized that UAC removal in extremely low birth weight (ELBW) neonates will result in significantly less phlebotomy blood loss (PBL) after correcting for severity of illness.
PBL was measured at a single center in 99 ELBW infants who survived to day 28. Individual infant's paired daily PBL for the two 24-h periods before and after UAC removal were compared using the paired t test. Daily PBL up to 7 days before and 7 days after UAC removal were compared using a logistic regression with mixed model analysis for repeated measures. Cumulative 28-day phlebotomy loss was evaluated by multiple linear regression analysis.
PBL 24 h before and after UAC removal were 1.7 mL (95% CI 1.5-1.9) and 0.9 mL (95% CI 0.8-1.0; p < 0.0001), respectively. Cumulative 28-day PBL increased by 2.2 mL (±0.7) per day that a UAC was present with or without correction for severity of illness (p < 0.001).
UAC removal is independently associated with a marked decline in PBL. We speculate the ease and convenience of UAC blood sampling lead to more frequent blood testing and greater PBL.
脐动脉导管（UAC）常用于重症新生儿。UAC 方便、可靠，并且允许护理人员在进行无痛动脉采血时方便操作。我们假设，在极低出生体重（ELBW）新生儿中，UAC 拔除后，在纠正疾病严重程度后，采血所致的失血（PBL）将显著减少。
在一家单中心，对 99 例存活至 28 天的 ELBW 婴儿测量了 PBL。使用配对 t 检验比较 UAC 拔除前后 24 小时内每个婴儿的每日配对 PBL。使用具有混合模型分析重复测量的逻辑回归比较 UAC 拔除前 7 天和后 7 天的每日 PBL。使用多元线性回归分析评估 28 天累积采血损失。
UAC 拔除前后 24 小时的 PBL 分别为 1.7 mL（95%CI 1.5-1.9）和 0.9 mL（95%CI 0.8-1.0；p < 0.0001）。UAC 存在时，无论是否校正疾病严重程度，28 天累积 PBL 每天增加 2.2 mL（±0.7）（p < 0.001）。
UAC 拔除与 PBL 显著下降独立相关。我们推测，UAC 采血的简便性导致了更频繁的血液检测和更多的 PBL。
