Schiff D E, Stonestreet B S
Department of Pediatrics, Women and Infants' Hospital of Rhode Island, Providence 02902.
J Perinatol. 1993 Mar-Apr;13(2):153-8.
To test the hypothesis that the incidence of central venous catheter-related complications is increased in very low (< 1000 gm) and low (1001 to 1500 gm) birth weight infants compared with larger infants, we retrospectively analyzed the charts of 51 infants with gestational ages 24 to 42 weeks, weighing 0.43 to 12.2 kg at catheter insertion, who had 69 catheters placed at 1 week to 11 months of age between January 1986 and June 1989 at our hospitals. The incidence of infectious and mechanical complications and the frequency of total and infection-related complications were significantly greater for infants weighing < 1000 gm at catheter insertion (p < 0.05). Oxacillin-resistant coagulase-negative Staphylococcus organisms accounted for 14 of the 17 episodes of catheter-related septicemia (82%). Six of these episodes were initially treated with antibiotics but without catheter removal; none resolved with catheter salvage. Central venous catheters in very low and low birth weight infants had an 85% and 64% incidence of associated complications, respectively, and should be used with caution in these patients.
为验证与中心静脉导管相关并发症的发生率在极低出生体重（<1000克）和低出生体重（1001至1500克）婴儿中高于较大婴儿这一假设，我们回顾性分析了1986年1月至1989年6月期间在我们医院接受治疗的51例胎龄24至42周、插管时体重0.43至12.2千克、年龄在1周龄至11月龄期间置入69根导管的婴儿病历。插管时体重<1000克的婴儿发生感染性和机械性并发症的发生率以及总的和与感染相关并发症的频率显著更高（p<0.05）。耐苯唑西林凝固酶阴性葡萄球菌占17例导管相关败血症发作中的14例（82%）。其中6例发作最初使用抗生素治疗但未拔除导管；无一例通过保留导管得以治愈。极低和低出生体重婴儿的中心静脉导管相关并发症发生率分别为85%和64%，在这些患者中应谨慎使用。
