65: Utilization of Central Lines in Canadian Neonatal Intensive Care Units
Bibliographic record
Abstract
Central venous and arterial lines are commonly used in NICUs to provide nutrition and medications and for monitoring of blood pressure; however they have the potential to contribute to serious complications. Knowledge of current practice is limited and larger cohort studies are warranted. To determine the trend and pattern of central catheter use for the period between 2005 and 2013 and identify variation amongst Canadian NICUs. A retrospective cohort study of neonates <30 weeks gestational age (GA) admitted between 2005 and 2013 was conducted using data from the Canadian Neonatal Network. Data on the use of central venous lines (CVLs) over three time periods (2005–2007, 2008–2010 and 2011–2013) while data on central arterial catheters (UACs) from 2010 to 2013 were examined. Baseline demographics and morbidities were compared between infants who had a central line and those who did not. 20792 infants <30 weeks were admitted during the study period. The use of central venous lines (CVL) increased since 2005–2007 for all GAs (Figure 1). This was due to an increase in UVC and PICC lines while the use of surgical CVLs decreased over time. CVL use varied significantly between units [AOR (95% CI) range: 0.10(0.05, 0.19) to 4.87 (2.35, 10.11)] (Figure 2). Infants who received CVLs had a significantly lower BW, GA and higher SNAP II scores than those who did not. SGA and surfactant use were more common in the CVL group. Multivariable analyses adjusting for GA, SNAP II and surfactant use showed that IVH ≥ grade 3, NEC, late onset sepsis and mortality were higher in the infants with CVLs (P<0.0001). There was a decrease in UAC use from 2010 to 2013 (P=0.002). CVL use in infants<30 weeks increased over the time period of this study in Canadian NICUs while UAC use decreased. The risk of mortality and major morbidities were increased among those who received CVLs. Further studies are warranted to develop standardized guidelines for central line insertion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".