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Objective:To study the clinical characteristics of hepatic injury following umbilical vein catheterization, so as to improve the safety and use of umbilical vein catheterization in the newborn.Methods:Data of infants undergoing umbilical vein catheterization during hospitalization in the neonatology department of the Third Affiliated Hospital of Guangzhou Medical University from Jan 1st, 2015 to Dec 31st, 2019 were collected retrospectively.The clinical characteristics, diagnoses and treatments of the infants with hepatic injury following umbilical vein catheterization were summarized and analyzed.And the relative literature was reviewed.Results:A total of 1 721 infants underwent umbilical vein catheterization, and seven cases(0.4%)had hepatic injury, including six cases of exudative necrosis in the liver and one case of hepatic hematoma.There was no significant difference in gestational age[(31.12±2.64)weeks vs.(30.62±2.75)weeks]or birth weight[(1 493±525)g vs.(1 374±473)g]between hepatic injury group and non-hepatic injury group( P>0.05). Clinically, it was found that the tip position of umbilical vein catheter was below the diaphragm(between the 9th and 11th thoracic vertebrae)in all seven cases.Except one case with no obvious clinical symptoms, the other six cases had clinical symptoms, mainly manifested as abdominal distension, repeated gastric retention, decreased bowel sounds, and additional with shock and anemia in hepatic hematoma.Blood sample tests showed elevated C-reactive protein, white blood cell count and transaminase.X-ray examination revealed cystic translucent shadow in the liver, and ultrasound and/or computed tomography examination showed the lesion in more detail.After removal of the catheter and administration of antibiotic, the hepatic injury recovered gradually. Conclusion:The hepatic injury following umbilical vein catheterization in neonates is not common.The catheter tip under the diaphragm is the main risk factor.And the diagnosis is dependent on imaging examination.
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Background: Umbilical vein catheter (UVC) insertion in newborns has life threatening complications like Catheter related bloodstream infections (CRBSI), Portal vein thrombosis (PVT) and other mild complications. This study has been done to assess the incidence and risk factors of complications in neonates with umbilical vein catheterisation.Methods: A prospective observational study was carried out in neonates admitted to a South Indian tertiary care hospital between January 2017- June 2018.Results: Umbilical vein catheterisation was done for 65 neonates, of them 46 completed the study. One neonate (2%) developed CRBSI and none of them developed PVT in both baseline and follow up scans. Minor complications noted were repositioning in 26%, umbilical site leak in 23%, reattempts in 19%, catheter block in 13%, periumbilical erythema in 6% and umbilical site bleed in 2%. There was no statistical significance between minor complications and baseline study characteristics.Conclusions: Although UVC is a common and easy vascular access, it is not without complications. Incidence of serious complications following umbilical vein catheterisation is low when proper technique and sterile precautions are followed. However, the occurrence of mild complications following UVC insertion is high.
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Objective To investigate the effect of blood specimen collection from umbilical vein catheter on catheter usage condition and relevant complications. Methods 80 premature infants with indwelling umbilical vein catheter were divided into the blood collection group and the non-blood collec-tion group, then the hospitalization time, catheter indwelling time and rate of catheter-related complications were compared. The 40 premature infants in the blood colleetion group were subsequently divided into the experimental group in which blood was collected from umbilical vein catheter and the control group in which blood was collected from peripheral blood vessel, then the blood collection time, success rate and influence on newborns were compared. Results There was no significant difference in hospitalization time, catheter indwelling time and rate of catheter-related complications between the blood collection group and the non-blood collection group. There was statistical significance in blood collection time, success rate and adverse reaction on suffering newborns between the experimental group and the control group. Conclusions There was no obvious influence on the regular service of the catheter if only the method is correct and operating procedure is normative, also it possesses advantages such as no pain, high success rate, peripheral vascular protection, etc. So, it can be used as one of the ways to collect blood speci-men for critical newborns.
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Umbilical catheters have been used in NICUs for drawing blood samples, measuring blood pressure, and administering fluid and medications for more than 50 years. When the patient does not need the umbilical catheter or complications associated with umbilical catheters have risen, the catheter must be removed. In this process, the catheter may snap or be cut off and the fragment may migrate to a near vessel or to the heart and cause infection, thrombosis, or arrythmia. We report a case where in the process of removing an umbilical vein catheter, the catheter was stuck to the dried umbilical cord and pulling at it caused the catheter to snap. An immediate roentgenogram showed the fragmented catheter had migrated to the left pulmonary artery. Using an intravascular snare with a femoral approach, we were able to collect the remaining catheter and remove it from the patient's body without any complications.