Advantages of being diligent: lessons learnt from umbilical venous catheterisation in neonates

Abiramalatha, Thangaraj; Kumar, Manish; Shabeer, Machilakath Panangandi; Thomas, Niranjan

doi:10.1136/bcr-2015-214073

Cited by 15 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Determining the correct tip position was found to be more accurate using ultrasound imaging compared to chest radiography, with higher sensitivity and specificity when using ultrasonography as shown in studies [9,10]. Repeated screening by ultrasonography or radiography to assess the correct umbilical venous catheter tip position at regular intervals until removal will help in the early detection of complications [11] or even the avoidance of some of these complications. Although pleural effusion is rare, it can lead to devastating, life-threatening complications.…”

Section: Discussionmentioning

confidence: 92%

A Rare Case of Umbilical Venous Catheter Malposition

Simreen,

Awaisheh,

Qtaishat

2024

Cureus

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 92%

A Rare Case of Umbilical Venous Catheter Malposition

Simreen,

Awaisheh,

Qtaishat

2024

Cureus

View full text Add to dashboard Cite

“…UVC catheter tip displacement can be affected by factors including pulmonary disease, diaphragm movement, mechanical ventilation pattern ( 19 , 20 ), abdominal circumference change ( 21 ), and umbilical stump contracture ( 2 ). The main diseases among our sample were NRDS in 41 patients (60.3%, 41/68) and mechanical ventilation in 53 patients (79.3%, 53/68).…”

Section: Discussionmentioning

confidence: 99%

Point-of-care ultrasound for monitoring catheter tip location during umbilical vein catheterization in neonates: a prospective study

Xie,

Liao

et al. 2023

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundPoint-of-care ultrasound (POCUS) can guide umbilical vein catheter placement in real time and monitor catheter tip position, allowing avoidance of severe complications due to catheter malposition. This study aims to explore the effectiveness of POCUS in guiding venous catheter insertion and monitoring complications.MethodsSixty-eight neonates with ultrasound-guided venous catheter insertion at the Neonatal Department of Dongguan Children's Hospital between December 2020 and February 2022 were included. POCUS was applied to monitor catheter tip location daily until catheter removal. A displacement range exceeding the intersection of the inferior vena cava and right atrium by ±0.5 cm was considered misalignment.ResultsSixty-four neonates had a displaced catheter tip (94.1%, 64/68), with a median displacement distance of 0.4 cm (minimum −0.2 cm, maximum 1.2 cm). Ten neonates had a misalignment (14.7%, 10/68) caused by displacement. Displacement usually occurs within 2–4 days after placement, with displacement rates of 94.1% (64/68), 90.6% (58/64), and 98.3% (59/60) on days 2, 3, and 4, respectively, and could still occur on day 9 post-placement. In addition, misalignment mainly occurs on the second day after placement. During the monitoring process, 58 neonates had catheter tip displacement ≥2 times, resulting in 252 displacement and 22 misalignment incidents. Among them, the catheter tip migrated outward from the inferior vena cava seven times, all of which were removed in time. Ultrasound was used for positioning 486 times, and x-ray was indirectly avoided 486 times.ConclusionThe catheter tip is prone to displacement and misalignment after umbilical vein catheterization, which most commonly occurs on days 2–4. POCUS is recommended for daily monitoring of the tip location during umbilical vein catheterization until catheter removal.

show abstract

Polycythemia and Hyperviscosity in Neonates

Linderkamp¹

2016

Neonatology

View full text Add to dashboard Cite

Polycythemia and the resulting increase in blood viscosity are common in the neonatal period. However, neonatal blood has several favorable properties including lower plasma viscosity, RBC aggregation, and increased red blood cell deformability compared with adults. Oxygen transport to vital organs is, therefore, usually not compromised when the hematocrit (HCL) is below 0.70 L/L. Polycythemia may develop before (increased erythropoiesis, prenatal transfusion syndromes) or after birth (late cord-clamping). Nevertheless, delayed or late cord-clamping should be encouraged because of favorable circulatory effectsamong other advantages. Signs of polycythemia often result from the underlying disorder (e.g., intrauterine asphyxia, maternal diabetes) rather than from the increased HCT and blood viscosity. Postnatal blood volume loss contributes to the development of polycythemia in most affected infants. Early oral feeding or, if necessary, additional i.v. fluid is therefore the first-line treatment and prophylaxis against polycythemia. Because partial exchange transfusion (PET) did not improve the long-term neurodevelopmental outcome and even increased the risk of early complications (necrotizing enterocolitis, septicemia) in polycythemic infants, indications for PET should respiratory distress requiring oxygen) with HCT !0.70 L/L. • PET should be done with normal saline.

show abstract

Advantages of being diligent: lessons learnt from umbilical venous catheterisation in neonates

Cited by 15 publications

References 14 publications

A Rare Case of Umbilical Venous Catheter Malposition

A Rare Case of Umbilical Venous Catheter Malposition

Point-of-care ultrasound for monitoring catheter tip location during umbilical vein catheterization in neonates: a prospective study

Polycythemia and Hyperviscosity in Neonates

Contact Info

Product

Resources

About