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CC BY 4.0 · Journal of Child Science 2020; 10(01): e230-e232
DOI: 10.1055/s-0040-1720957
Case Report

Parenteral Nutrition Ascites: Calamity from an Umbilical Vein Cannula

Vishnu Anand
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Femitha Pournami 
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Anila V. Panackal
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Anand Nandakumar
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Jyothi Prabhakar
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
,
Naveen Jain
1   Department of Neonatology, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
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Abstract

Umbilical vein catheterization is considered a critical requirement in preterm neonates for the administration of fluids and parenteral nutrition. However, inadvertent migration and malposition are known to cause complications that are often life-threatening. We describe a neonate with parenteral nutrition-associated lipid ascites owing to extravasation from an umbilical vein cannula. Fatality was averted due to prompt recognition and paracentesis that was therapeutic and confirmed the diagnosis as well.

Keywords

umbilical vein cannula - parenteral nutrition - ascites


Publication History

Received: 09 September 2020

Accepted: 03 October 2020

Article published online:
18 December 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Dubbink-Verheij GH, Visser R, Tan RNGB, Roest AAW, Lopriore E, Te Pas AB. Inadvertent migration of umbilical venous catheters often leads to malposition. Neonatology 2019; 115 (03) 205-210
    CrossrefPubMedGoogle Scholar
  • 2 Lean WL, Dawson JA, Davis PG, Theda C, Thio M. Accuracy of five formulae to determine the insertion length of umbilical venous catheters. Arch Dis Child Fetal Neonatal Ed. 2019; Mar; . Epub 2018 Mar 17. PMID: 29550770 104 (02) F165-F169 DOI: 10.1136/archdischild-2017-314280.
    CrossrefPubMedGoogle Scholar
  • 3 Hermansen MC, Hermansen MG. Intravascular catheter complications in the neonatal intensive care unit. Clin Perinatol. 2005; Mar; , vii. doi: 10.1016/j.clp.2004.11.005. PMID: 15777826 32 (01) 141-156
    CrossrefPubMedGoogle Scholar
  • 4 Abiramalatha T, Kumar M, Shabeer MP, Thomas N. Advantages of being diligent: lessons learnt from umbilical venous catheterisation in neonates. BMJ Case Rep 2016; 2016: bcr2015214073 DOI: 10.1136/bcr-2015-214073.
    CrossrefPubMedGoogle Scholar
  • 5 Michel F, Brevaut-Malaty V, Pasquali R. et al. Comparison of ultrasound and X-ray in determining the position of umbilical venous catheters. Resuscitation 2012; 83 (06) 705-709
    CrossrefPubMedGoogle Scholar
  • 6 Pulickal AS, Charlagorla PK, Tume SC, Chhabra M, Narula P, Nadroo AM. Superiority of targeted neonatal echocardiography for umbilical venous catheter tip localization: accuracy of a clinician performance model. J Perinatol 2013; 33 (12) 950-953
    CrossrefPubMedGoogle Scholar
  • 7 Derinkuyu BE, Boyunaga OL, Damar C. et al. Hepatic complications of umbilical venous catheters in the neonatal period: the ultrasound spectrum. J Ultrasound Med 2018; 37 (06) 1335-1344
    CrossrefPubMedGoogle Scholar
  • 8 Grizelj R, Vukovic J, Bojanic K. et al. Severe liver injury while using umbilical venous catheter: case series and literature review. Am J Perinatol 2014; 31 (11) 965-974
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Kirkpatrick AW, Roberts DJ, De Waele J. et al. Pediatric Guidelines Sub-Committee for the World Society of the Abdominal Compartment Syndrome. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 2013; 39 (07) 1190-1206
    CrossrefPubMedGoogle Scholar
  • 10 Pegu S, Murthy P. Ascites with hepatic extravasation of total parenteral nutrition (TPN) secondary to umbilical venous catheter (UVC) malposition in an extremely preterm baby. BMJ Case Rep 2018; 2018: bcr2018226377 DOI: 10.1136/bcr-2018-226377.
    CrossrefPubMedGoogle Scholar
  • 11 Lee HM, Sung HJ, Lee Hs. Umbilical venous catheter complications presenting as chylous ascites in a newborn: Intraperitoneal extravasation of total parenteral nutrition infusate. Neonatal Med 2018; 25 (04) 196-201
    CrossrefPubMedGoogle Scholar