Umbilical Venous Catheter vs Umbilical Artery Catheter

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 495-495
Author(s):  
Joseph A. Kitterman
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Umbilical Artery ◽  
Newborn Infants ◽  
Venous Catheter ◽  
Invasive Procedures ◽  
Relative Ease ◽  
Mixed Venous Saturation ◽  
Sick Newborn ◽  
The Right ◽  
Mixed Venous

In their commentary,1 Drs Dudell, Cornish, and Bartlett note that the measurement of mixed venous saturation (SVo2) is routine for infants receiving extracorporeal membrane oxygenation; in such infants, SVo2 can be measured easily without further invasive procedures. The authors recommend that clinicians use SVo2 measurements "more routinely" in other sick newborn infants and state that the measurement can be made with "relative ease" by inserting an umbilical venous catheter into the right atrium. This recommendation raises some concerns:

UMBILICAL VESSEL ANGIOCARDIOGRAPHY IN THE NEWBORN INFANT

PEDIATRICS ◽  
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.

The potential of accurate SVO2 monitoring during venovenous extracorporeal membrane oxygenation: an in vitro model using ultrasound dilution

Perfusion ◽  
2007 ◽  
Vol 22 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Joshua Walker ◽  
Johanna Primmer ◽  
Bruce E. Searles ◽  
Edward M. Darling
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Oxygen Saturation ◽  
Ecmo Circuit ◽  
Ultrasound Dilution ◽  
Membrane Oxygenation ◽  
Mixed Venous Saturation ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Line Oxygen ◽  
Mixed Venous ◽  
Vv Ecmo

Introduction. Some degree of recirculation occurs during venovenous extracorporeal membrane oxygenation (VV ECMO) which, (1) reduces oxygen (O2) delivery, and (2) renders venous line oxygen saturation monitoring unreliable as an index of perfusion adequacy. Ultrasound dilution allows clinicians to rapidly monitor and quantify the percent of recirculation that is occurring during VV ECMO. The purpose of this paper is to test whether accurate patient mixed venous oxygen saturation (SVO2) can be calculated once recirculation is determined. It is hypothesized that it is possible to derive patient mixed venous saturations by integrating recirculation data with the ECMO circuit arterial and venous line oxygen saturation data. Methods. A test system containing sheep blood adjusted to three venous saturations (low-30%, med-60%, high-80%) was interfaced via a mixing chamber with a standard VV ECMO circuit. Recirculation, arterial line and venous line oxygen saturations were measured and entered into a derived equation to calculate the mixed venous saturation. The resulting value was compared to the actual mixed venous saturation. Results. Recirculation was held constant at 30.5 ± 2.0% for all tests. A linear regression comparison of “actual” versus “calculated” mixed venous saturations produced a correlation coefficient of R2 = 0.88. Direct comparison of actual versus calculated saturations for all three test groups respectively are as follows; Low: 31.8 ± 3.95% vs. 37.0 ± 6.7% (NS), Med: 61.7 ± 1.5% vs. 72.3 ± 1.8% (p < 0.05), High: 84.4 ± 0.9% vs. 91.2 ± 1.1% (p < 0.05). Discussion. There was a strong correlation between actual and calculated mixed venous saturations; however, significant differences between actual and calculated values where observed at the Med and High groups. While this data suggests that using quantified recirculation data to calculate SVO2 is promising, it appears that a straightforward derivative of the oxygen saturation-based equation may not be sufficient to produce clinically accurate calculations of actual mixed venous saturations. Perfusion (2007) 22, 239—244.

Thrombotic Complications of Umbilical Artery Catheters: A Clinical and Radiographic Study

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 374-379
Author(s):  
Boyd W. Goetzman ◽  
Robert C. Stadalnik ◽  
Hugo G. Bogren ◽  
Willard J. Blankenship ◽  
Richard M. Ikeda ◽  
...  
Keyword(s):  
Umbilical Artery ◽  
Newborn Infants ◽  
Direct Result ◽  
Thrombotic Complication ◽  
Reliable Technique ◽  
Arterial Blood ◽  
Sick Newborn ◽  
Thrombotic Complications ◽  
Umbilical Artery Catheterization ◽  
Blood Specimens

Catheterization of the aorta via the umbilical artery provides a convenient route for monitoring arterial blood pressure, for obtaining blood specimens for measurement of blood gas tensions and chemistries, and for the infusion of fluids and pharmacologic preparations in sick newborn infants. Use of this technique may be accompanied by a number of complications of which thrombotic phenomena are the most common. Twenty-three of 98 (24%) newborn infants undergoing umbilical artery catheterization were found to have thrombotic complications determined by aortography. No correlation was present between the duration of time that the umbilical artery catheters were in place and the occurrence of thrombotic complications. From paired aortographic or aortographic and autopsy studies in 24 patients, it was concluded that if a thrombotic complication did not occur early, none was likely to occur subsequently. One patient was considered to have died as a direct result of a thrombotic complication. Aortography is a safe, simple, and reliable technique for the early detection of thrombotic complications of umbilical artery catheters. Umbilical artery catheterization is not without risk and careful selection of patients for this procedure is indicated.

Perforation of the right ventricle by a pulmonary artery catheter that continues to measure cardiac output and mixed venous saturation

2005 ◽  
Vol 17 (2) ◽  
pp. 124-127 ◽  
Author(s):  
Kuan-Chih Chuang ◽  
Albert Kok-Mao Lan ◽  
Hsiang Ning Luk ◽  
Chi-Shien Wang ◽  
Chia-Jung Huang ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Catheter ◽  
Mixed Venous Saturation ◽  
The Right ◽  
Mixed Venous

scholarly journals Calculating mixed venous saturation during veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2009 ◽  
Vol 24 (5) ◽  
pp. 333-339 ◽  
Author(s):  
Joshua L. Walker ◽  
Jonathan Gelfond ◽  
Lee Ann Zarzabal ◽  
Edward Darling
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Mixed Venous Saturation ◽  
Mixed Venous

Extracorporeal Membrane Oxygenation

1991 ◽  
Vol 7 (S1) ◽  
pp. 52-55 ◽  
Author(s):  
George Lister
Keyword(s):  
Gas Exchange ◽  
Extracorporeal Membrane Oxygenation ◽  
Right Atrium ◽  
Femoral Vein ◽  
Newborn Infants ◽  
Peak Inspiratory Pressure ◽  
Permeable Membrane ◽  
Membrane Oxygenation ◽  
The Right ◽  
Extracorporeal Oxygenation

Extracorporeal membrane oxygenation (ECMO) is a means of diverting a fraction or all of the circulation through a device that permits gas exchange across a permeable membrane. The site of removal and the site of return of blood are dictated primarily by practical considerations based on the volume of flow of blood to be diverted and whether a particular organ is to be bypassed. The prototype of extracorporeal oxygenation is heart-lung bypass, used for various types of cardiac surgery, in which the entire venous return is diverted through an oxygenator (bubble or membrane type) and returned to the aorta. Since the earliest reports of the use of ECMO in neonates, venoarterial bypass has been the preferred route, with blood drained from the right atrium and returned either to the carotid artery or to the femoral artery, although the former seems to have been used most often (2;4;11;12;14;18). In some reports, veno-venous bypass has also been accomplished with removal of blood from the right atrium and return into the umbilical or femoral vein (13;19). Gas exchange across the lung may also continue, although the ventilator rate, tidal volume, or peak inspiratory pressure are usually reduced markedly during the period of extracorporeal oxygenation. Anticoagulation is accomplished with few problems by infusion of heparin sulfate throughout the duration of the procedure. There now have been enough reports in the literature (individual cases or series of patients) to demonstrate that the procedure can be carried out with a minimum of technical difficulties in newborn infants (2;3;4;11;12;18), although the selection of “appropriate” patients reduces the morbidity and technical challenges of the procedure.

Immunologic Studies of Antithrombin III Heparin Cofactor in the Newborn

1978 ◽  
Vol 39 (03) ◽  
pp. 624-630 ◽  
Author(s):  
W E Hathaway ◽  
L L Neumann ◽  
C A Borden ◽  
L J Jacobson
Keyword(s):  
Gestational Age ◽  
Antithrombin Iii ◽  
Newborn Infants ◽  
Term Infant ◽  
Sick Newborn ◽  
At Iii ◽  
Thrombotic Complications ◽  
Low Levels ◽  
Collection Methods ◽  
Made In

SummarySerial quantitative immunoelectrophoretic (IE) measurements of antithrombin III heparin cofactor (AT III) were made in groups of well and sick newborn infants classified by gestational age. Collection methods (venous vs. capillary) did not influence the results; serum IE measurements were comparable to AT III activity by a clotting method. AT III is gestational age-dependent, increasing from 28.7% of normal adult values at 28-32 weeks to 50.9% at 37-40 weeks, and shows a gradual increase to term infant levels (57.4%) by 3-4 weeks of age. Infants with the respiratory distress syndrome (RDS) show lower levels of AT III in the 33-36 week group, 22% vs. 44% and in the 37-40 week group, 33.6% vs. 50.9%, than prematures without RDS. Infants of 28-32 week gestational age had only slight differences, RDS = 24%, non-RDS = 28.7%. The lowest levels of AT III were seen in patients with RDS complicated by disseminated intravascular coagulation and those with necrotizing enterocolitis. Crossed IE on representative infants displayed a consistent pattern which was identical to adult controls except for appropriate decreases in the amplitude of the peaks. The thrombotic complications seen in the sick preterm infant may be related to the low levels of AT III.

A central venous catheter in the right vertebral vein.

1993 ◽  
Vol 161 (4) ◽  
pp. 908-908 ◽  
Author(s):  
M Kontrus ◽  
M L Pretterklieber ◽  
M T Farres
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Central Venous ◽  
The Right

scholarly journals Successful removal of a central venous catheter misplaced in the right subclavian artery using an intravascular stent: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Haruka Yoshida ◽  
Shinichiro Ikemoto ◽  
Yasuyuki Tokinaga ◽  
Kanako Ejiri ◽  
Tomoyuki Kawamata
Keyword(s):  
Central Venous Catheter ◽  
Subclavian Artery ◽  
Axillary Artery ◽  
Insertion Site ◽  
Venous Catheter ◽  
Central Venous ◽  
Thrombotic Complications ◽  
Successful Removal ◽  
Intravascular Stent ◽  
The Right

Abstract Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

The value of real-time ultrasound-guidance for definite placement of a right supraclavicular subclavian central venous catheter

2021 ◽  
pp. 112972982199853
Author(s):  
Jens M Poth ◽  
Stefan F Ehrentraut ◽  
Se-Chan Kim
Keyword(s):  
Ultrasound Guidance ◽  
Venous Catheter ◽  
Needle Insertion ◽  
Major Surgery ◽  
Axillary Vein ◽  
Central Venous ◽  
Supraclavicular Fossa ◽  
The Right ◽  
High Index Of Suspicion ◽  
Insertion Process

Central venous catheters (CVC) are widely used in critically ill patients and in those undergoing major surgery. Significant adverse events, such as pneumothorax and hemothorax, can be caused by needle insertion during CVC insertion. CVC misplacement is less often described, yet equally important, as it can lead to deleterious complications. Here, we describe a case in which misplacement of a guidewire following infraclavicular puncture of the right axillary vein was detected by continuous ultrasound employing the right supraclavicular fossa view. Utilizing this ultrasound view, the insertion approach to the vessel was changed and correct CVC placement could be achieved. While ultrasound guidance is widely accepted for vessel puncture, this case demonstrates the value of continuous ultrasound guidance for the entire process of CVC insertion: vessel puncture, correct guidewire advancement, catheter placement, and exclusion of complications such as pneumothorax. It also shows that there should be a high index of suspicion for guidewire misplacement, even after successful venipuncture. In conclusion, ultrasound protocols covering the complete CVC insertion process should be implemented into current clinical practice.

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