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Long Term Effect Of UVC ?


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Hi every one >>

i want to ask about long term effect of ucv and in specific on the liver ..

ita not uncommon for the uvc to be placed in the liver , usualy we take it out and (if possible ) inserting another one (hopefully in the right position )

but some Neonatologist advice to leave it if the only solution passing through it is N/s (for couple of days) 

so .. is there any study done to adress the long term effect on the liver in case of wrong placement ?

some times i dont feel in hurry to change it , so how serous is the wrong uc placement >??

 

thanks in advance 

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We have all faced this conundrum but ultimately the risk of malposition has been highlighted in a number of reports such as

 
Grizelj R. Severe liver injury using umbilical venous catheter: case series and literature review. Am J Perinatology 2014 Nov; 31(11): 965-74
Fuchs EM. Umbilical venous catheter-induced hepatic hematoma in neonates. Journal of neonatal-perinatal medicine 2014 Jan 1;7(2): 137-43 
 
As a result our unit  introduced ultrasound confirmation in an effort to mitigate complications, shorten duration of UVC line insertion time and decrease risk of litigation, we also adopted a policy of restricting indwelling umbilical catheter duration to no more than 7 days based on older studies indicating an increase in infection risk and thrombus formation. The latter article I have attached as an interesting read albeit from 2009
 
Kind regards
Ricky Dippenaar
 
 

UmbilicalVein1.pdf

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hi 

have any of you noted another interesting finding with regards to UVC insertions in preterm.

we have noticed that our radiologists (we have noted as well) often report about a lucency around UVC tips on X-rays. there is a high incidence of UVC related complications when we see such things on X-rays. Not exactly sure what these lucencies may indicate? - surrounding hepatoma or air around the catheter?

any similar experience or any other thoughts?

Shri 

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