Aims and objectives
Umbilical vein catheterization was performed in response to the need to administer medication to neonates.(1).These catheters have been widely used in neonatal intensive care rooms since 1947(2).Umbilical venous catheterization often leads to complications.(3).Many of these complications may be associated with incorrect positioning of the catheter.(4).Correct positioning of catheters can be done by conventional radiography or ultrasound(5).Current evidence supports the use of ultrasound to locate the tip of the catheter.(6).There is a greater risk of mechanical complications associated with improper positioning of the tip of the...
Methods and materials
We used ultrasound evaluation to diagnose the presence of portal system-related complications in these patients.
We studied 45 neonates with umbilical vein catheters who were admitted to the NICU of the MPCH from May to September 2018. They were evaluated by performing serial abdominal ultrasounds,
immediately after catheter placement,
from 1 to 3 days,
from 4 to 7 days and weekly after that.
The follow-up period varied from 2 to 58 days,
with an average of 13 days of evaluation per subject.
The ultrasonographic assessment...
Results
We studied a total of forty-five neonates.
Twenty-three of these were (51.11%) female and 22 (48.89%).
(See Fig. 3,
Graphic 1).
The dominant gestational age group was extreme prematurity with 20 neonates (44.44%).
(See Fig. 4,Graphic 2).
Of the 45 neonates with umbilical vein catheterization,
36 (80.00%) presented complications (See Fig. 5,Graphic 3).
The most frequent complications were portal pneumatosis with a frequency of 71.11%,
followed by liver hematomas with 28.89%,
portal thrombosis with a frequency of 4.4% and portal cavernomatosis with 2.2 %.
(See...
Conclusion
The incorrect positioning of the umbilical venous catheter occurs frequently (86.6%) in the NICU and this is usually caused by not using imaging guided catheterization.
Ultrasound should be used to guide the correct positioning of the catheter or to check its placement if it is suspected that it was incorrectly positioned so that it can then be withdrawn.
(2).
The incorrect positioning of the umbilical vein catheter has a statistically significant relationship (p = 0.001) with the presence of portal system complications overall (pneumatosis,
thrombosis...
Personal information
1.Juan Pablo Ramírez Delgado
Medical Resident.
Radiology Service.
"Miguel Pérez Carreño" Hospital.
Central University of Venezuela (UCV).
Surgeon (UCV).
Public Health Inspector (UCV).
Address: Quenda Urbanization,
Residences Q,
Tower 1,
Floor 3,
Apartment 3B,
Los Teques,
Miranda State,
Venezuela.
Zip code: 1201
Phone: +584241300078
+584125585172
E-mail:
[email protected]
2.Maria Ximena Escovar
Medical Resident.
Radiology Service.
"Miguel Pérez Carreño" Hospital.(UCV).
References
1.
Cáceres GU,
Pérez HM,
Ugalde JH,
Gamboa IA.
Associated complications due to umbilical catheters in neonates.
Rev Mex Pediatr [Internet] 2007; 74 (2); 70-73.
Available at: http://www.medigraphic.com/pdfs/pediat/sp-2007/sp072d.pdf
2.
Fuentealba I,
Retamal A,
Ortiz G,
Pérez M.
Radiological evaluation of catheters in neonatal ICU.
Rev Chil Pediatr [Internet] 2014; 85 (6): 724-730 doi: 10.4067 / S0370-41062014000600011.
Available at: http://www.elsevier.es/es-revista-revista-chilena-pediatria-219-articulo-evaluacion-radiologica-cateteres-uci-neonatal-X0370410614766041
3.
Sánchez VX,
Carbonell EM,
Esqué R,
Barjau C,
Mingueza L.
Giraldó LC.
Invasive catheters in the newborn.
Fetal medicine and neonatology.
An Esp Pediatr [Internet]...