Professional paper
Umbilical Vein Catheterization - When Complications Occur A Case Report
IVA BILIĆ ČAČE
; University Hospital Centre Rijeka, Department of Gynecology and Obstetrics, Division of Neonatology, Krešimirova 43, 51000 Rijeka, Croatia
ROBERT KRAJINA
; University Hospital Centre Rijeka, Department of Gynecology and Obstetrics, Division of Neonatology, Krešimirova 43, 51000 Rijeka, Croatia
NEVEN ČAČE
; University Hospital Centre Rijeka, Department of Pediatrics
Abstract
Although umbilical venous catheterization is a routine procedure in premature newborns, it is associated with various,
potentially life threatening, complications. We present a case of a premature baby diagnosed with a hepatic parenchymal
liquid collection as a complication of umbilical vein catheterization in our Neonatal Intensive Care Unit.
The child was born in the 25th gestational week (GW) and was doing well until the12th day of life when his general condition
deteriorated. He appeared anxious and his oxygen saturation (SaO2) decreased. There was slight abdominal distension
and tenderness over the abdominal wall, with weak bowel movements, and a palpable liver. Abdominal ultrasound (US)
showed an enlarged liver with a well-defined hypoechoic area, with inhomogeneous echogenicity. Such findings were
suggestive of fluid extravasation to the liver through a malpositioned umbilical venous catheter. The umbilical catheter was
withdrawn, antimicrobial treatment initiated, and eventual complete regression of the collection was seen eleven days after
extravasation. Rapid, unexplained clinical deterioration of a newborn with an umbilical vein catheter should always raise the
suspicion of a complication due to catheterization. Such a catheter should be carefully revised and, if there is any doubt,
removed. Timely diagnosis and adequate treatment is essential, and potentially life-saving.
Keywords
newborn; umbilical vein catheterization; complication; malposition; liver
Hrčak ID:
134115
URI
Publication date:
1.10.2013.
Visits: 1.043 *