Severe Liver Injury while Using Umbilical Venous Catheter: Case Series and Literature Review

Abstract

In all neonates with liver injury, UVC was malpositioned within the portal circulation. Despite the fact that our report provides only circumstantial evidence for the mechanism of injury, it supports reports which suggest that "low" UVC position increases potential for this type of complication. Acute onset of abdominal distension in a neonate with UVC should prompt ultrasonographic evaluation of position of the catheter tip.

Ultrasound assessment of umbilical venous catheter migration in preterm infants: a prospective study

“…The complications associated with malpositioned UVC include pericardial effusion, cardiac tamponade,5 6 pleural effusion,7 8 thrombosis,9 10 cardiac arrhythmias,11 endocarditis,12 liver haematoma,13 diffuse liver injury14 and portal hypertension 15…”

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

“…Our literature review revealed that risks are associated with both central 12,14,26 and low-lying UVC positioning. 4,25,31,34 There is little guidance, however, on how the UVCs should be used.…”

Nabelvenenkatheter in der neonatologischen Intensivbehandlung – Teil 2

“…In einer retrospektiven Studie an 210 Frühgeborenen mit einem Geburtsgewicht < 1250 g betrug die Rate an Pfortaderthrombosen 10 % und in einer weiteren Analyse an 109 Früh-und Reifgeborenen sogar 43 % [25]. Hauptrisikofaktoren sind ▪ die NVK-Malposition, d. h. eine zu kaudale und nicht-zentrale Katheterposition, ▪ eine ungewöhnlich lange Katheterliegezeit und ▪ die Infusion von Blutprodukten [17,18,26].…”