Abstract
Objective The aim of the study is to identify the rates and trends of various procedures performed
on newborns.
Study Design The Healthcare Cost and Utilization Project (HCUP) database for the years 2002 to
2015 was queried for the number of livebirths, and various procedures using International
Classification of Diseases, Ninth Revision (ICD-9) codes. These were adjusted to the
rate of livebirths in each particular year. A hypothetical high-volume hospital based
on data from the last 5 years was used to estimate the frequency of each procedure.
Results Over the study period, there was a decline in the rates of exchange transfusions
and placement of arterial catheters. There was an increase in the rates of thoracentesis,
abdominal paracentesis, placement of umbilical venous catheter (UVC) lines, and central
lines with ultrasound or fluoroscopic guidance. No change was observed in the rates
of unguided central lines, pericardiocentesis, bladder aspiration, intubations, and
LP. Intubations were the most performed procedures. Placement of UVC, central venous
lines (including PICCs), arterial catheters, and LP were relatively common, whereas
others were rare such as pericardiocentesis and paracentesis.
Conclusion Some potentially lifesaving procedures are extremely rare or decreasing in incidence.
There has also been an increase in utilization of fluoroscopic/ultrasound guidance
for the placement of central venous catheters.
Key Points
-
Advances in neonatal care have impacted the number of procedures performed in the
NICU.
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It is unclear whether invasive procedures occur at rates sufficient for adequate training
and maintenance of skills.
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Understanding the NICU procedural trends is important in designing simulation and
competency-based medical education programs.
Keywords
pericardiocentesis - paracentesis - thoracentesis - exchange transfusion - lumbar
puncture - bladder aspiration - arterial catheterization - umbilical catheter
