Vascular device practices in extremely preterm infants: an international cross-sectional survey

OBJECTIVE: To explore global practices in vascular device selection, securement, and monitoring for extremely preterm infants, and to assess regional variation. STUDY DESIGN: A web-based cross-sectional survey was completed by one respondent per neonatal unit. RESULT: We received 848 responses from 100 countries. Guideline availability varied: 85-98% for umbilical venous catheters (UVCs) and 29-97% for peripheral intravenous catheters. UVCs were the preferred initial vascular device at 23 to 26 weeks (70% and 63%, respectively). Transparent film dressings for peripheral catheters and Wharton's jelly stitch for UVCs were the commonest securement methods. Peripherally inserted central catheter sites were assessed at intervals of < 8 h in 56% (434/780) units, and 58% (490/848) units did not use an extravasation injury detection tool. Guideline availability was two-fold higher in units caring for 22-23 vs 24-25 weeks' gestation. CONCLUSION: Significant global variation exists, highlighting the need for standardized, evidence-based vascular care.