ABSTRACT
Umbilical vessel catheterization is common practice for infants in the neonatal intensive care unit (NICU). Umbilical venous catheters (UVC) although very useful as a means of obtaining vascular access, do not come without risks. Here we will describe three separate cases of infants in the NICU who, during their course of treatment, were found to have hepatic masses attributed to UVC misplacement. Two of the cases presented incidentally and one presented acutely. We believe liver hematomas may be a more common complication of malpositioned UVCs than previously believed. An appreciation of the complications of malpositioned UVCs should alert clinicians to screen for potential complications and to ensure ideal line placement.
Subject(s)
Catheterization/adverse effects , Catheters, Indwelling/adverse effects , Hematoma/diagnostic imaging , Hepatomegaly/diagnostic imaging , Liver/injuries , Umbilical Veins/diagnostic imaging , Abdomen/diagnostic imaging , Catheterization/standards , Clinical Competence , Female , Hematoma/etiology , Hematoma/prevention & control , Hepatomegaly/etiology , Humans , Infant, Newborn , Intensive Care, Neonatal , Liver/diagnostic imaging , Male , Practice Guidelines as Topic , Ultrasonography , Umbilical Veins/injuriesABSTRACT
XAD resins are commonly used to recover and concentrate organics from chlorinated water. It was found that the action of residual chlorine on XAD-4 resin produced mutagenic artifacts in a dose dependent manner. The production of mutagenic artifacts could be suppressed at least ten-fold by converting free chlorine to monochloramine. Kinetic studies of the reaction between free chlorine and XAD-4 resin showed a reaction rate dependence upon pH and chloride ion concentration that suggests participation of species besides hypochlorous acid.
