BROKEN MBILICAL CATHETER IN NEONATES - AN UNUSUAL PREVENTABLE COMPLICATION NEERAJ AGGARWAL, RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, INDIA
International Conference on PEDIATRICS AND NEONATOLOGY
July 25-26, 2019 | Amsterdam, Netherlands
Rajiv Gandhi University of Health Sciences, India
Keynote : Curr Pediatr Res
Introduction: Although Umbilical vein and arterial catheter (UVC and UAC) is generally considered to be safe, various
complications like thrombus formation and infection are commonly reported but emboli due to fragmentation of the
catheter is uncommon. We are describing successful retrieval of broken and migrated UVC and UAC in 2 neonates. Also
the literature review was done to ascertain the causes and advise preventive measures in such cases.
Case: In a newborn, UVC got divided by a scalpel at the skin level while removing the retaining suture and migrated to portal vein . Fluoroscopy guided removal of catheter was done through 4 mm Gooseneck snare via Umbilical venous route. In second case, broken UAC catheter was removed from the descending aorta via femoral arterial route.
Discussion: The umbilical catheter can get inadvertently damaged by needles or scissors during catheter insertion and fixation. Subsequent attempts of removal of this weakened catheter may cause breakage. Overzealous tightening of a purse string type suture used to secure a catheter can also weaken the wall of UVC. This underscores the importance of using fine suture removal scissors especially in an active neonate who may be difficult to restrain. One should always inspect the tip of the removed catheter for its intactness , record the length of catheter at the time of insertion and removal and also insist for a check radiograph, since small broken fragment tip from these long catheters can be overlooked and missed.