Positioning and complications of umbilical catheters

Abstract

Umbilical catheters have

been used for decades in neonatal care. There are many advantages to using

them, but they also carry risks of complications. The general aim of this

thesis is to optimize positioning of umbilical catheters and to improve their use, thus limiting complications. To predict the correct insertion length of umbilical catheters we recommend the use of a simple method without complex body measurements or combined calculations. However, no method or formula has been proven to reliably predict the correct insertion length. Moreover, umbilical venous catheters (UVCs) tend to migrate even after correct positioning. Regular evaluation of the position of UVCs - preferably by ultrasonography, and starting during or directly after placement - is therefore advised to prevent complications caused by malpositioning. Physicians using UVCs should be aware of the possible complications described in this thesis, such as thrombosis, bloodstream infections and cardiac arrhythmias. However, despite the risk of complications umbilical catheterization is an excellent method for gaining intravenous access in sick infants, especially in cases of extremely premature birth or haemodynamic instability.