Incorrect umbilical vein catheterization is associated with severe periventricular hemorrhages and mortality in extremely premature newborns

Kurtom, Waleed; Quast, Deborah; Worley, Leslie; Oelberg, David G.

doi:10.3233/npm-16915060

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…Umbilical venous catheters (UVCs) were associated with multiple complications, including catheter-associated bloodstream infections (CABSIs), (2,3) venous thrombosis, (4) and hepatic (5) and cardiac (6,7) complications, although the relative incidence is not well established. (8) Proper catheter position is important to avoid the development of severe complications.…”

Section: Introductionmentioning

confidence: 99%

A review of umbilical venous catheter-related complications at a tertiary neonatal unit in Singapore

Goh¹,

Kan²,

Bharadwaj³

et al. 2021

smedj

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Section: Introductionmentioning

confidence: 99%

A review of umbilical venous catheter-related complications at a tertiary neonatal unit in Singapore

Goh¹,

Kan²,

Bharadwaj³

et al. 2021

smedj

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“…It can guide UVC in real time and monitor the catheter tip position ( 5 ). Early detection of catheter tip displacement can effectively prevent arrhythmia, pericardial effusion ( 6 ), pericardial tamponade ( 7 ), endocarditis, pleural effusion ( 8 ), liver hemorrhage, liver tissue necrosis ( 9 ), and other serious complications. In this study, 68 neonates with ultrasound-guided venous catheter insertion were prospectively assessed.…”

Section: Introductionmentioning

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.

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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.

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“…These include pericardial effusion and tamponade, pleural effusions, hepatic hematomas, cardiac arrhythmias, hepatic or abdominal abscesses, ascites, and central line-associated bloodstream infections. [3][4][5][6][7][8][9][10][11][12][13] Rarer complications reported in some cases related to UVCs include myocardial infarction, necrotizing enterocolitis, and renal failure. 31,42,43 However, rates of complications with UVC positions are not well described.…”

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confidence: 99%

Central versus Low-Lying Umbilical Venous Catheters: A Multicenter Study of Practices and Complications

et al. 2018

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Objectives Conventional neonatology practice is to place umbilical venous catheters (UVCs) in central position and to limit the use of low-lying catheters. Our objectives were to describe the practices and complications associated with UVCs and to evaluate the type of infusates used with either UVC position. Study Design A retrospective chart review was performed at four neonatal intensive care units to identify neonates who underwent UVC placement over a 2-year period. Infant demographics, UVC position, catheter days, fluid and medication characteristics, and specific complications were extracted. Results A total of 2,011 neonates who underwent UVC placement were identified during the 2-year period. Of these, 641 UVCs (31.9%) were identified in the low-lying position. Centrally positioned UVCs were associated with lower gestational age and were left in situ for a longer duration than low-lying UVCs. Infusions of hyperosmolar solutions and vasopressors were significantly higher in central UVCs, though they were used in a significant number of low-lying UVCs. Complications, while not statistically different, were three times higher in low-lying UVCs. Conclusion Despite conventional teaching, low-lying UVCs were used in nearly one-third of infants in this cohort. Parenteral nutrition, antibiotics, and vasopressors were infused through central and low-lying UVCs. There was no statistically significant difference in complication rates between UVC positions.

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Incorrect umbilical vein catheterization is associated with severe periventricular hemorrhages and mortality in extremely premature newborns

Abstract: In extremely premature newborns, incorrect UVC placement is significantly associated with death through its relation to severe periventricular hemorrhage.

Cited by 5 publications

References 15 publications

A review of umbilical venous catheter-related complications at a tertiary neonatal unit in Singapore

A review of umbilical venous catheter-related complications at a tertiary neonatal unit in Singapore

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

Central versus Low-Lying Umbilical Venous Catheters: A Multicenter Study of Practices and Complications

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