We had a preterm born at 32 weeks readmitted at 35 weeks with serum bilirubin of 32 mgs. Our pediatric surgeon did the cut down of umbilical vein and helped us to cannulate. We could only do 10 ml two alliquotes exchange. Though we could push in blood it was difficult to withdraw blood. We adjusted recannulated and nothing worked. It was late in the night. We could not call him again at 11 pm. So we cannulated the saphenous vein at medial malleolus and tried peripheral exchange. Though it worked and we could exchange 230 ml for this 1.4 kg baby, fingers hurt till next day.

What you do in this situation when you don't have help available and scary about central vein placement ?

P.S. Can any one teach the fine art of central veIn cannulation in this tiny tots or any we based learning modules?

thanks,

dr.r.selvan

Edited May 5, 201016 yr by selvanr4

I think you will find this very informative:

Raichur D, Wari PK, Kasturi AV, Savitha D. Peripheral vessel exchange

transfusion. Indian Pediatr. 1999 Sep;36(9):914-7. PubMed PMID: 10744871.

LINK