In-line filtration in very preterm neonates: a randomized controlled trial

• Published in: Scientific reports Vol. 10; no. 1; p. 5003
• Main Authors: Virlouvet, Anne-Laure, Pansiot, Julien, Toumazi, Artemis, Colella, Marina, Capewell, Andreas, Guerriero, Emilie, Storme, Thomas, Rioualen, Stéphane, Bourmaud, Aurélie, Biran, Valérie, Baud, Olivier
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 19.03.2020; Nature Publishing Group
• Subjects: 692/308/3187; 692/420/256; 692/499; 692/53/2421; 692/53/2422; Clinical trials; Critical Illness - therapy; Cytokines; Cytokines - blood; Filtration; Human health and pathology; Humanities and Social Sciences; Humans; Infant, Extremely Premature; Infants; Inflammation; Inflammation Mediators - blood; Infusions, Intravenous - adverse effects; Infusions, Intravenous - instrumentation; Infusions, Intravenous - methods; Life Sciences; multidisciplinary; Neonates; Newborn babies; Pediatrics; Prognosis; Santé publique et épidémiologie; Science; Science (multidisciplinary); Time Factors; Vascular Access Devices
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-020-61815-4

In-line filtration is increasingly used in critically-ill infants but its benefits, by preventing micro-particle infusion in very preterm neonates, remain to be demonstrated. We conducted a randomized controlled trial among very preterm infants allocated to receive either in-line filtration of all the intra-venous lines or standard care without filters. The primary outcome was differences greater than 20% in the median changes in pro-inflammatory cytokine serum concentrations measured at day 3 and day 8 (+/−1) using a Luminex multianalytic profiling technique. Major neonatal complications were analyzed as secondary predefined outcomes. We randomized 146 infants, assigned to filter (n = 73) or control (n = 73) group. Difference over 20% in pro-inflammatory cytokine concentration between day 3 and day 8 was not found statistically different between the two groups, both in intent-to-treat (with imputation) and per protocol (without imputation) analyses. The incidences of most of neonatal complications were found to be similar. Hence, this trial did not evidence a beneficial effect of in-line filtration in very preterm infants on the inflammatory response syndrome and neonatal morbidities. These data should be interpreted according to local standards in infusion preparation and central line management.