Christensen Michael L, Abbruzese Lucas, Herrera Oscar, Weems Mark F
Department of Clinical Pharmacy and Translational Science (MLC, LA, OH), University of Tennessee Health Science Center, Department of Pediatrics (MLC, MFW), University of Tennessee Health Science Center, Memphis, TN.
Pharmacy Department (MLC, LA, OH), Le Bonheur Children's Hospital, Neonatal Intensive Care Units (MFW), Le Bonheur Children's Hospital, Memphis, TN.
J Pediatr Pharmacol Ther. 2024 Dec;29(6):610-613. doi: 10.5863/1551-6776-29.6.610. Epub 2024 Dec 9.
The use of umbilical artery catheters (UACs) for parenteral nutrition (PN) administration is controversial, and limited data exist on the safety of administration through this route. The objective of this research is to evaluate neonates who received PN through a UAC and assess catheter-related complications and PN composition.
This retrospective study evaluated all neonates who received PN through their UAC while admitted in the neonatal intensive care unit between January 2019 and December 2022. Neonates were evaluated for development of catheter-related complications such as infiltration, extravasation, thrombus formation, infection, or hypertension.
The administration of PN through UAC was identified in 31 neonates. Among the 31 neonates, 17 (55%) were classified as preterm, and 15 (48%) were classified as low birth weight. No patient experienced a UAC-related complication. Death occurred among 7 (23%) neonates. Two deaths occurred while the neonates were receiving PN via the UAC, but neither death was attributed to UAC complications. In 19 (61%) of the 31 neonates, osmolarity of PN exceeded 900 mOsm/L.
Results of this study suggest that UACs may serve as a safe route for PN administration in neonates. The absence of catheter-related complications and the absence of adverse events support the safety of this approach. Further research with a larger sample size and rigorous study design is warranted to validate these findings and establish guidelines for the use of UACs in PN administration.
使用脐动脉导管（UAC）进行肠外营养（PN）给药存在争议，且关于通过该途径给药安全性的数据有限。本研究的目的是评估通过UAC接受PN的新生儿，并评估导管相关并发症和PN成分。
这项回顾性研究评估了2019年1月至2022年12月在新生儿重症监护病房住院期间通过UAC接受PN的所有新生儿。评估新生儿是否发生导管相关并发症，如渗漏、外渗、血栓形成、感染或高血压。
31例新生儿通过UAC接受了PN给药。在这31例新生儿中，17例（55%）为早产儿，15例（48%）为低出生体重儿。没有患者发生与UAC相关的并发症。7例（23%）新生儿死亡。2例死亡发生在新生儿通过UAC接受PN期间，但均非由UAC并发症所致。在31例新生儿中的19例（61%）中，PN的渗透压超过900 mOsm/L。
本研究结果表明，UAC可能是新生儿PN给药的安全途径。未出现导管相关并发症和不良事件支持了这种方法的安全性。有必要进行更大样本量和更严格研究设计的进一步研究，以验证这些发现并制定UAC在PN给药中使用的指南。
