Inadvertent Migration of Umbilical Venous Catheters Often Leads to Malposition
Autor: | Remco Visser, Enrico Lopriore, Arjan B. te Pas, Ratna N G B Tan, Arno A.W. Roest, Gerdina H. Dubbink-Verheij |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Male
Umbilical Veins medicine.medical_specialty 03 medical and health sciences Catheters Indwelling 0302 clinical medicine Foreign-Body Migration Standard care Umbilical venous catheters 030225 pediatrics Catheterization Peripheral medicine Humans Prospective Studies 030212 general & internal medicine Migration Ultrasonography Original Paper business.industry Infant Newborn Surgery Position (obstetrics) medicine.anatomical_structure Infant Extremely Low Birth Weight Infant Extremely Premature Pediatrics Perinatology and Child Health Right atrium Female Radiography Thoracic business Malposition Developmental Biology |
Zdroj: | Neonatology, 115(3), 205-210 |
Popis: | Background: Migration of umbilical venous catheters (UVCs) has been described anecdotally. Objectives: The aim of this paper was to investigate migration of UVCs using ultrasonography (US). Methods: In a prospective observational study, the position of UVCs was determined using serial US within 24 h, at midweek, and at the end of the week after umbilical catheterization. Migration was recorded in distance and direction. Malposition was defined as a position of the UVC in the heart (right atrium or more distal along the UVC-route), umbilicoportal confluence, or in the umbilical vein. UVC position determined by US was compared with chest X-rays (CXRs) when these were performed for standard care within the same period of 1 h. Results: Migration of UVCs was detected with US in 25/40 infants (63%) in 32 occasions, leading to malposition in 17/25 (68%) infants. UVCs migrated inwards in 18/32 (56%), leading to a position within the heart in 17/18 occasions. Most migrations occurred before Day 3 (21/32 [66%]). When a CXR was taken at the same time as US was performed (30 occasions), the assessment of the catheter-tip position differed in 23% of the occasions. When malposition was detected by US, this was detected on routinely performed CXRs in 11% of the occasions. Conclusions: UVCs often migrate following insertion, often leading to malposition. Awareness for this is needed, and US is a feasible alternative for detecting malposition compared to CXRs and avoids additional radiation. Re-evaluation of the position of UVCs at least once, but within 24 h after placement, is recommended. |
Databáze: | OpenAIRE |
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