An Unusual Complication of Umbilical Artery Catheterization

Attention is called to the clinical course of a neonate who experienced the accidental retro-grade loss of part of a polyvinyl catheter into the aorta. This had occurred after treatment via an umbilical artery had been completed, and attempts to remove the catheter had resulted in its breaking. The management of this problem is presented, and the various complications of umbilical vessel cathethenization are reviewed.

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Contamination of Umbilical Vessel Catheters: Encouraging Information

PEDIATRICS ◽

10.1542/peds.49.3.470 ◽

1972 ◽

Vol 49 (3) ◽

pp. 470-471

Author(s):

William F. Powers ◽

William H. Tooley

Keyword(s):

Bacterial Contamination ◽

Umbilical Artery ◽

Umbilical Vein ◽

Bacterial Colonization ◽

Significant Risk ◽

The Other ◽

Umbilical Vessel ◽

Other Hand ◽

Umbilical Artery Catheterization ◽

Recent Editorial

In his recent editorial, Dr. Cook1 mentions bacterial contamination as one of the complications of umbilical artery catheterization, and refers to a report by Krauss, et al.2 who grew bacteria from 6 of 11 (55%) umbilical artery catheters. Balagtas, et al.3 have also published similar findings with umbilical vein catheters, 52% of which had bacterial colonization on removal. These reports stress the significant risk of generalized infection with umbilical vessel catheters. On the other hand, Casalino and Lipsitz4 report a 5% incidence of bacterial contamination.

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Complications of Umbilical Vessel Catheterization: Peritoneal Perforation

PEDIATRICS ◽

10.1542/peds.44.6.1028 ◽

1969 ◽

Vol 44 (6) ◽

pp. 1028-1030

Author(s):

G. Van Leeuwen ◽

M. Patney

Keyword(s):

Umbilical Artery ◽

Community Hospital ◽

Umbilical Vein ◽

Potential Danger ◽

Umbilical Vessel ◽

Reticular Pattern ◽

Vein Catheter ◽

Peritoneal Perforation ◽

Umbilical Artery Catheterization ◽

Umbilical Vein Catheter

Umbilical artery catheterization has been performed for approximately 6 years for diagnostic and investigative studies, and more recently for intravascular fluid therapy. We recently encountered a complication—perforation of the peritoneum—which illustrates another potential danger of this procedure. CASE REPORT Baby Y., a 1,590 gm female infant, was delivered in a community hospital. She was delivered with membranes intact but aspirated amniotic fluid containing meconium when the membranes were removed. At 20 minutes of age examination revealed marked intercostal retractions, a respiratory rate of 60 per minute, and cyanosis. Roentgenograms of the chest showed a fine reticular pattern. An umbilical vein catheter was inserted, but blood could not be aspirated.

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UMBILICAL VESSEL ANGIOCARDIOGRAPHY IN THE NEWBORN INFANT

PEDIATRICS ◽

10.1542/peds.31.6.946 ◽

1963 ◽

Vol 31 (6) ◽

pp. 946-951

Author(s):

Samuel O. Sapin ◽

Leonard M. Linde ◽

George C. Emmanouilides

Keyword(s):

Newborn Infant ◽

Umbilical Artery ◽

Umbilical Vein ◽

Newborn Infants ◽

Umbilical Vessel ◽

Accurate Interpretation ◽

Sick Newborn

Angiocardiography from an umbilical vessel approach was performed in 10 critically sick newborn infants. The umbilical vein route was successfully employed up to the eighth day of life, while the umbilical artery was safely used as late as age 5 days. This approach has advantages over other methods of catheterization and angiocardiography. Angiocardiographic quality was satisfactory for accurate interpretation.

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Check Umbilical Catheter Position

PEDIATRICS ◽

10.1542/peds.54.3.384 ◽

1974 ◽

Vol 54 (3) ◽

pp. 384-384

Author(s):

Philip D. Szold

Keyword(s):

Case Report ◽

Umbilical Artery ◽

Catheter Position ◽

X Ray ◽

Umbilical Catheter ◽

Umbilical Artery Catheterization

On reading the brief recording, "Gangrene of the Buttock: A Complication of Umbilical Artery Catheterization,"1 I was convinced that because the contribution was included in Experience and Reason, the conclusion would be to always obtain an adequate x-ray after catheterization to verify proper positioning. Such an x-ray was not obtained until more than 30 hours postcatheterization in the above-mentioned case report. However, I reached the end of the article with no mention of the importance of these x-ray studies.

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Neonatal Bladder Injury Occurring After Umbilical Artery Catheterization by Cutdown

JAMA ◽

10.1001/jama.1983.03340210066029 ◽

1983 ◽

Vol 250 (21) ◽

pp. 2968 ◽

Cited By ~ 3

Author(s):

Joel M. Kaufman

Keyword(s):

Umbilical Artery ◽

Bladder Injury ◽

Umbilical Artery Catheterization

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ADVANTAGES AND COMPLICATIONS OF UMBILICAL ARTERY CATHETERIZATION IN THE NEWBORN

PEDIATRICS ◽

10.1542/peds.42.5.769 ◽

1968 ◽

Vol 42 (5) ◽

pp. 769-777

Author(s):

William D. Cochran ◽

Heather T. Davis ◽

Clement A. Smith

Keyword(s):

Fluid Therapy ◽

Causes Of Death ◽

Umbilical Artery ◽

Fluid Administration ◽

Blood Sampling ◽

Indwelling Catheter ◽

Local Complications ◽

Arterial Blood ◽

Umbilical Artery Catheterization

During a period of 5 years, 8 months, umbilical artery catheterization was performed on 387 infants in a newborn nursery. The indwelling catheter, at first introduced only to secure arterial blood for diagnostic and investigative purposes, was subsequently employed for intravascular fluid therapy in the same infant, and ultimately (in 51 of the 387 infants) for such fluid therapy alone. Complications observed were either vasospasm and temporary blanching of an extremity (13 infants: 11 surviving without apparent sequelae, 2 dying but without local complications at autopsy) or thrombosis, arteritis, or other inflammation noted at postmortem (18 infants). Such complications were not causes of death at autopsy, but their finding suggests the need for limiting the procedure to infants in whom any other route of blood sampling or fluid administration is particularly difficult.

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