Umbilical Catheter Complications in Newborns during Prone Position: A Pilot Study

Introduction: It is not known whether prone position of newborns with umbilical catheters increases the complication risk. Purpose: Analysing complications of umbilical catheters in newborns during prone positioning and analysing if local complications as a wet or red rim increase severe complications. Subjects: Newborns (< 24 weeks 42 weeks gestational age) with an umbilical catheter, inserted on our third level 17-bed neonatal care unit. Design: A prospective observational pilot study (during September 2009-September 2010). Methods: Each neonate was positioned for at least 12 hours in 48 consecutive hours in the prone position. Results: 88 newborns were included. Central line associated bloodstream infection was the main reason for catheter removal due to complications. A wet or red umbilical rim did not increase the major complications. The relative risk for central line associated bloodstream infection in case of pus excretion was 3.3 as compared with clean umbilical stump (p = 0.015). There were no complications as excessive blood loss or obstructions. Conclusion: An umbilical catheter should not be considered as a contraindication for prone positioning. In case of wet rim or pus excretion from the umbilical stump, removal of the catheter should be seriously considered.