Aims Central vascular access is imperative in the treatment of critically ill neonates in intensive care. In our unit we use femoral lines when other possible routes are not feasible. A recent survey found that only 40% of UK NICUs use femoral lines due to the technical challenges for insertion and the concerns regarding complications such as infection and ischaemic injury. The aim of this study was to establish the rate of non-infectious complications and the rate of Catheter Associated Bloodstream Infection (CABSI) associated with femoral vascular access during a 5 year period.
Methods All femoral lines inserted between 2008 and 2012 were identified using the electronic patient record. The records were checked for evidence of ischaemic, haemorrhagic or other complications. All episodes of CABSI during any period of femoral vessel catheterisation were identified, using a standard definition, by cross referencing with the microbiology database.
Results 117 femoral central catheters were used in 94 babies in the period between 2008 and 2012. Of them 52 were arterial and 65 were venous. The median (range) birth weight and gestation were 955 (410–4610) g and 27 (23–42) weeks.
There were 581days of care with a femoral line and 11 CABSI. This gives a CABSI rate of 18.9 per 1000 catheter days. The rate appeared to be higher in venous lines than in arterial lines (Table 1). There was a decrease in the rate over the study period from 57.7/1000 in 2008 to 9.5/1000 in 2012 (Table 2).
There were no episodes of ischaemic injury to the leg, episodes of haemorrhage or any other non-infectious complications associated with femoral lines.
Conclusion Femoral vascular lines can be used for central vascular access on the neonatal unit. We have not experienced any significant non-infections complications. The rate of infection appears to be broadly similar to the rate seen with other forms of central venous access in this population.
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