I have one question regarding the correct timing for inserting a UVC for realizing an exchange transfusion. Is there any literature regarding after how many days is it correct to insert a UVC, without a risk of NEC or other type of infections due to the colonization of the umbilical stump?

Thank you

I have searched PubMed for literature about your question above, without success.

Our strategy is to use the umbilical vein if it is possible to catheterize it (circle argumentation...), i.e. the first few days postpartum.

For us, exchange transfusion is a really rare procedure, and the few exchange transfusions we need to do are virtually all related to hemolytic disease that is evident early postpartum (typically during the 1st or 2nd postnatal day).

Not exactly to the point but very informative

http://www.adhb.govt.nz/newborn/guidelines/vascularcatheters/UmbilicalCatheters.htm

We seem to have a lot of ABO incompatibilities, and have external patients that are admitted on their third or fourth day of life, with bilirrubin around 30 mg dl that need exchangetransfusions, but we were wondering if there was any contraindication to insert an UVC after the third day.....or up to which day is it safe to do it without a risk for NEC.

Thanks again.....

I would think that a UVC (see also link shared by JACK above) that is correctly positioned is ok under these circumstances.

usually till one week after it becomes difficult to cannulate as stump dries out.Then use other sites-Peripheral arteries /PICC

or you can ask the pediatric surgeon to do a cut down just above umbilicus.

I have successfully managed to insert a UVC on Day 14 of life for exchange transfusion,without any complications.

I wonder what was the indication to place UVC at day 14 ?

I.e Abo or Rh happen very early .. G6PD ? Or just breast feeding hyperbilirubinemia ?

It was an Out-born / neglected case of hyperbilirubinemia due to ABO incompatibility. Sadly it was only by the 14th day did they realize something was wrong with their baby.

No issues with days, as long as you can successfully treat the problem. You know the risk - outcome benefit. a dose of flucloxacillin might help around the time of insertion.