Broviac catheterization in low birth weight infants: Incidence and treatment of associated complications

Fifty-two Broviac catheters were inserted in 40 preterm and eight term infants for 1733 days of catheter use. Thirty-six (69%) catheters were associated with complications of infection and/or thrombosis, a complication rate of 1/48 catheter days. The patients who developed complications were of a significantly lower gestational age and had a lower mean birth weight when compared with those who developed no complications. The incidence of catheter-related sepsis was 69% in the very low birth weight infants and only 20% in the infants with birth weights over 1500 g. Eighteen of the 26 catheter-associated infections were treated with antibiotics without catheter removal. Successful resolution of the infections with retention of the catheter occurred in 14 of the 18 episodes. Infections with Staphylococcus aureus constituted three of four treatment failures. Urokinase infusion was successful in causing thrombolysis in eight of the nine cases. Broviac catheters in neonates, and especially in preterm infants under 1500 g, are associated with a high incidence of complications. Our experience indicates that some complications can be selectively managed without sacrificing the venous access.