Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

https://doi.org/10.5281/zenodo.10616402

Infections related to the use of central venous catheters in critically ill

neonates

Infecciones relacionadas con la utilización de catéteres venosos centrales en

neonatos críticos

Vladimir Vega-Falcón

ua.vladimirvega@uniandes.edu.ec

Universidad Regional Autónoma de los Andes, Ambato, Tungurahua,

Ecuador

https://orcid.org/0000-0003-0140-4018

ABSTRACT

Objective: to analyze infections related to the use of central venous catheters in critically ill neonates.

Method: descriptive documentary type, the search included specialized databases, including

PubMed, Scielo, Scopus and Web of Science (Wos). Results and conclusion: The vulnerability of

neonates, combined with invasive procedures and prolonged hospital stays, creates an environment

conducive to the proliferation of microorganisms, making catheters potential portals of entry. The

literature review highlights the paradox between the utility and risks associated with catheters.

Although they are indispensable for specialized intravenous treatments, their use carries significant

threats that can prove fatal to neonates.

Descriptors: catheters; catheter obstruction; catheter-related infections. (Source, DeCS).

RESUMEN

Objetivo: analizar las infecciones relacionadas con la utilización de catéteres venosos centrales en

neonatos críticos. Método: De tipo descriptivo documental, la búsqueda abarcó bases de datos

especializadas, incluyendo PubMed, Scielo, Scopus y Web of Science (Wos). Resultados y

conclusión: La vulnerabilidad de los neonatos, combinada con procedimientos invasivos y estancias

hospitalarias prolongadas, crea un entorno propicio para la proliferación de microorganismos,

convirtiendo a los catéteres en posibles portales de entrada. La revisión bibliográfica resalta la

paradoja entre la utilidad y los riesgos asociados a los catéteres. Aunque son indispensables para

tratamientos intravenosos especializados, su uso conlleva amenazas significativas que pueden

resultar fatales para los recién nacidos.

Descriptores: catéteres; obstrucción del catéter; infecciones relacionadas con catéteres. (Fuente,

DeCS).

Received: 12/09/2023. Revised: 09/18/2023. Approved: 10/21/2023. Published: 01/01/2024.

Brief original

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

INTRODUCTION

In the present study, the problem of infections related to the use of central venous

catheters in critically ill neonates is comprehensively addressed, constituting a topic

of substantial relevance in neonatal medical care. The presence of these devices,

although crucial for the administration of intravenous therapies, is associated with a

significant increase in the risk of infectious complications. This research aims to

study in depth the nature of such infections, evaluating predisposing factors, clinical

manifestations, preventive measures and therapeutic strategies, with the objective

of offering a significant contribution to the improvement of clinical management and

quality of care in this delicate group of patients.

The aim is to analyze infections related to the use of central venous catheters in

critically ill neonates.

METHOD

An exhaustive search for scientific articles related to infections associated with the

use of central venous catheters in critically ill neonates was carried out. The search

included specialized databases, including PubMed, Scielo, Scopus and Web of

Science (Wos). A total of 15 relevant studies were selected, following inclusion

criteria based on methodological quality, thematic relevance and timeliness of the

information.

The methodology employed was based on a descriptive documentary approach,

where relevant data from the selected articles were collected, examined and

classified. Priority was given to the identification of key variables related to the

incidence, risk factors, clinical manifestations and preventive and therapeutic

strategies of central venous catheter-associated infections in critically ill neonates.

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

The analytical-synthetic method was applied to integrate and analyze the information

extracted from the selected studies, which allowed the identification of patterns,

trends and discrepancies in the literature, thus contributing to a deeper

understanding of the problem addressed. Data synthesis was carried out by

categorizing common findings and formulating conclusions that consolidated the

available scientific evidence.

The present study adhered to fundamental ethical principles, guaranteeing

confidentiality and respect for the rights of the participants in the studies analyzed.

The ethical regulations of the institutions involved in the original research of the

selected articles were respected.

The analysis of the information was carried out through the application of statistical

and qualitative techniques pertinent to the nature of the data collected. We sought

to identify causal relationships, temporal trends, and modulating factors that would

contribute to a comprehensive understanding of central venous catheter-associated

infections in critically ill neonates.

This methodological section provides a robust basis for the exploration and in-depth

analysis of central venous catheter-associated infections in critically ill neonates,

ensuring the validity and reliability of the results obtained.

RESULTS

Technological progress in neonatal intensive care units has transformed the

therapeutic landscape, significantly increasing survival rates in premature infants.

However, this progress brings with it crucial challenges for neonatal nurses,

highlighting the need to establish safe and long-lasting vascular access. In this

context, the percutaneous peripherally inserted catheter emerges as a reliable tool,

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

facilitating effective central venous access, minimizing painful punctures and the

stress associated with constant manipulation of neonates.

1 2 3

Despite their efficacy, the use of central venous catheters has become essential in

critical neonatal areas, especially in situations requiring prolonged intravenous

treatments. Percutaneous insertion of silicone catheters, known as central venous

catheterization, presents significant advantages but, at the same time, increases the

risk of infections, constituting a substantial challenge in neonatal care.

4 5

It is imperative to emphasize that the risk factors associated with catheter insertion

and indwelling, both central and peripheral, can trigger complications that contribute

to high morbidity and mortality rates in neonatal intensive care units. The

vulnerability of neonates, coupled with invasive procedures and prolonged hospital

stays, creates an environment conducive to the proliferation of microorganisms, with

catheters serving as portals of entry.

6 7

The literature review conducted highlights the paradox between the utility of

catheters and their associated risks. Although these devices are essential for highly

concentrated and long-lasting intravenous treatments, their use also carries serious

threats that can prove fatal to neonates. It is crucial to recognize the importance of

careful handling and proper aseptic measures by healthcare personnel, especially

nurses, who play a critical role in the placement and maintenance of these devices.

8 9

The inversely proportional relationship between the risk of infection and gestational

age, birth weight, immune system immaturity and the prescription of broad-spectrum

antibiotics underscores the complexity of catheter management in critically ill

neonates. Recognition of these risk factors, as well as the implementation of

multidisciplinary strategies to mitigate them, proves essential to optimize safety and

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

efficacy in the administration of intravenous therapies in this vulnerable population.

10 11 12

In summary, the use of central venous catheters in critically ill neonates is an

essential tool, but not without its challenges. A thorough understanding of the risk

factors, the implementation of preventive measures and meticulous attention during

the handling of these devices are fundamental to minimize the associated

complications, preserving the integrity and health of neonates in critical settings.

14 15

CONCLUSION

The risk factors inherent to the insertion and indwelling of catheters, both central and

peripheral, are a relevant concern that can trigger complications, raising morbidity

and mortality rates in neonatal intensive care units. The vulnerability of neonates,

combined with invasive procedures and prolonged hospital stays, creates an

environment conducive to the proliferation of microorganisms, making catheters

potential portals of entry.

The literature review highlights the paradox between the utility and risks associated

with catheters. Although they are indispensable for specialized intravenous

treatments, their use carries significant threats that can prove fatal to neonates. It is

imperative to recognize the importance of careful handling and proper aseptic

measures, especially by nursing staff, who play a critical role in the placement and

maintenance of these devices.

The complexity of catheter management in critically ill neonates is reflected in the

inversely proportional relationship between the risk of infection and gestational age,

birth weight, immune system immaturity and the prescription of broad-spectrum

antibiotics. Recognition of these risk factors and the implementation of

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

multidisciplinary strategies are essential to optimize safety and efficacy in the

administration of intravenous therapies in this vulnerable population.

The use of central venous catheters in critically ill neonates is crucial but not without

challenges. A thorough understanding of risk factors, implementation of preventive

measures and meticulous care during the handling of these devices are fundamental

to minimize associated complications, preserving the integrity and health of

neonates in critical settings.

FUNDING

Non-monetary

CONFLICT OF INTEREST

There is no conflict of interest with persons or institutions involved in the research.

ACKNOWLEDGMENTS

To the health personnel concerned with restoring the health of neonates.

REFERENCES

1. Gorla BC, Jorge BM, Rueda A, Belmonte AC, Berchelli F. Catéter venoso central

de corta duración: producción de vídeos educativos para el equipo de

enfermería [Short-term central venous catheter: production of educational

videos for the nursing team]. Esc. Anna Nery. [Internet].2021;26(2):2-8.

Disponible en: http://old.scielo.br/pdf/ean/v26/en_1414-8145-ean-26-

e20210392.pdf

2. Lona JC, Gómez LM, Cordero A, Cortés S, Quiles M, Pérez R, Pinto H.

Incidencia y factores asociados a candidiasis invasiva en una unidad de

cuidados intensivos neonatales de México [Incidence and factors associated

with invasive candidiasis in a neonatal intensive care unit in Mexico]. Asoc. Esp.

Ped. [Internet].2021;96(6):465554.

3. García A, Castellano JL,Fuenets C,Garcia JM,Fernandez JR,Gomez E, García

V. Cinco pasos para la disminución de las infecciones relacionadas con la

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

asistencia sanitaria en prematuros [Five steps to reduce healthcare-associated

infections in preterm infants]. An.Pediatr.[Internet].2017;87(1):26–33.

4. Aguilar L, Abad F, Chávez M, La Rosa J, Loayza K, Ríos K. Utilización del catéter

venoso central de inserción periférica en la Unidad de Cuidados Intensivos

Neonatales del Instituto Nacional de Salud Del Niño Breña, 2017–2019 [Use of

peripherally inserted central venous catheter in the Neonatal Intensive Care Unit

of the Breña National Institute of Child Health, 2017–2019]. An. Fac. Med.

[Internet]. 2022;83(3):1-5.

5. Domínguez J, Sarango Sandoya K, Salazar ZK. Infecciones producto de catéter

venoso central y factores asociados en neonatos del Hospital José Carrasco

Arteaga [Central venous catheter-related infections and associated factors in

neonates at the José Carrasco Arteaga Hospital]. Rev.Inv.Sal.

[Internet].2021;4(12):634–646.Disponible en:

http://www.scielo.org.bo/pdf/vrs/v4n12/2664-3243-vrs-4-12-200.pdf

6. Herrera E, Ortunio M, Rivas A, Guevara H. Infecciones asociadas al cuidado de

la salud en neonatos [Health care-associated infections in neonates]. Arch.

Venez. Pueric. Pediatr. [Internet].2017;80(3): 88-91.

7. Padilla C, Montejano Benavent L, Monedero A, Borras MJ, Selfa A, Riera MJ.

Factores de riesgo asociados a eventos adversos en recién nacidos portadores

de catéteres centrales de inserción periférica [Risk factors associated with

adverse events in newborns with peripherally inserted central catheters].

Enferm.Intens. [Internet].2021; 30(4):170–180.

8. Ruiz C, Jaramillo LI, Martínez LM, Villegas JD, Álvarez LF, Builes LN. Trombosis

asociada a catéter venoso central [Central venous catheter-associated

thrombosis]. Acta. Pediatr. Mex. [Internet].2021;42(5): 25159.

9. Bodenham A. Acceso vascular [vascular access]. Rev médica Clín Las Condes

[Internet]. 2017;28(5):713–26.

10. Chulle CM, Llerena RB, Jiménez EE, Vicharra J, Zeladita JA. Práctica de

enfermería en la inserción y mantenimiento del catéter percutáneo en neonatos

de un hospital público, Callao, 2010-2015 [Nursing practice in the insertion and

maintenance of the percutaneous catheter in neonates of a public hospital,

Callao, 2010-2015]. Ágora. Rev. Cient. [Internet].2020;07(01):1–6.

11. Agüero NS, Meza GE. Infecciones asociadas a catéter venoso central en

pacientes internados en el servicio de pediatría del Hospital Central del Instituto

de Previsión Social de abril del 2020 abril de 2021 [Central venous catheter-

associated infections in patients admitted to the pediatric service of the Central

Hospital of the Social Welfare Institute on April 2020 April 2021]. Rev. Cient.

Cienc. Salud. [Internet].2021;3(4):78–84.

12. Cabrera DM, Cuba FK, Hernández R, Ruiz Y. Incidencia y factores de riesgo de

infecciones del torrente sanguíneo asociadas a catéter central [Incidence and

Sanitas

Revista arbitrada de ciencias de la salud

Vol. 3(1), 24-31, 2024

Infecciones relacionadas con la utilización de catéteres venosos centrales en neonatos

críticos

Infections related to the use of central venous catheters in critically ill neonates

Vladimir Vega-Falcón

risk factors of central catheter-associated bloodstream infections]. Rev. Perú.

Med. Exp. Salud Publica. [Internet].2020;38(1):634–646.

13. Sun SM, Chen YY. Hu Li Za Zhi. 2018;65(5):68-79.

doi:10.6224/JN.201810_65(5).09

14. Mahieu LM, De Muynck AO, Ieven MM, De Dooy JJ, Goossens HJ, Van

Reempts PJ. Risk factors for central vascular catheter-associated bloodstream

infections among patients in a neonatal intensive care unit. J Hosp Infect.

2001;48(2):108-116. doi:10.1053/jhin.2001.0984

15. Moon HM, Kim S, Yun KW, et al. Clinical Characteristics and Risk Factors of

Long-term Central Venous Catheter-associated Bloodstream Infections in

Children. Pediatr Infect Dis J. 2018;37(5):401-406.

doi:10.1097/INF.0000000000001849

and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

International (CC BY-NC-SA 4.0) licence.

https://creativecommons.org/licenses/by-nc-sa/4.0/