Umbilical line fixation and CLABSI rates
Abstract:
Background: Fixing umbilical lines using medical adhesives raises concern of skin injury, creating a potential source of infection increasing the likelihood of central associated blood stream infection (CLABSI). Considering this, we adapted an alternate method of non-adhesive vertical suspension technique for fixation of umbilical lines. This study compared CLABSI rate between suspension method and conventional method.
Methods: This before-after design (observational study) included preterm neonates <32 weeks of gestational age (GA) who required umbilical line insertion. Suspension technique for fixation of umbilical lines was adopted from October, 2024. Based on the technique, neonates were grouped as ADHESIVE group (AG) admitted between October 2023 and September 2024, and SUSPENSION group (SG) admitted between October 2024 and March 2025. Propensity matching for GA formed a matched cohort of 60 neonates. Outcome of the study included comparison of CLABSI rate among two groups, and skin injury and displacement of umbilical lines in SG.
Results: Out of 60 matched neonates, 30 were included in the SG. CLABSI rate in the SG and AG was 6.2 and 30.1, respectively (RR- 0.20, 95% CI 0.004-1.83). According to McNemar’s test SG had a significant lower CLABSI rate (p < 0.001).
Conclusion: This study highlights the feasibility of the non-adhesive suspension technique as a method to fix umbilical catheter with no associated skin injury and displacement. Though there was no difference in CLABSI rate overall, with propensity matching for GA, this technique had lower CLABSI rate. Future larger studies are needed to evaluate efficacy of this technique.
Reference:
Vahnita T, Balakrishnan U, Amboiram P, Pradhan S. Effect of non-adhesive suspension method for fixing umbilical lines on CLABSI in preterm neonates – A propensity score matched study. J Neonatal Perinatal Med. 2025 Sep 29:19345798251380176. doi: 10.1177/19345798251380176. Epub ahead of print. PMID: 41020341.