TY - JOUR AU - Grizelj, Ruza; Vukovic, Jurica; Bojanic, Katarina; Loncarevic, Damir; Stern-Padovan, Ranka; Filipovic-Grcic, Boris; Weingarten, Toby N.; Sprung, Juraj TI - Severe Liver Injury while Using Umbilical Venous Catheter: Case Series and Literature Review SN - 0735-1631 SN - 1098-8785 PY - 2014 JO - Am J Perinatol JF - American Journal of Perinatology LA - EN VL - 31 IS - 11 SP - 965 EP - 974 ET - 2014/03/03 DA - 2014/10/13 KW - catheter malposition KW - complications KW - liver injury KW - thoracoabdominal radiographs KW - ultrasonography KW - umbilical venous catheter AB - Objective Proper position of umbilical venous catheter (UVC) is of importance to avoid severe complications. We review clinical presentations of neonates with UVC who developed catheter-associated liver injury.Study Design We reviewed institutional intensive care database (2008–2013) and identified neonates with UVCs who developed severe hepatic injury. We recorded admission diagnosis, gestational age, birth weight, number of days the umbilical catheter was in place, its radiological position at insertion and at the time of injury, presenting clinical signs, and outcomes.Results Of 1,081 neonates, 9 (0.8% [95% exact binomial confidence interval, 0.4–1.6%]) with UVC developed severe hepatic injury. All had the UVC malpositioned within the liver circulation. All presentations were life threatening, with acute abdominal distension (hepatomegaly) being the most consistent sign. Two neonates died from complications which were unrelated to catheter-associated liver injury.Conclusions: In all neonates with liver injury, UVC was malpositioned within the portal circulation. Despite the fact that our report provides only circumstantial evidence for the mechanism of injury, it supports reports which suggest that “low” UVC position increases potential for this type of complication. Acute onset of abdominal distension in a neonate with UVC should prompt ultrasonographic evaluation of position of the catheter tip. PB - Thieme Medical Publishers DO - 10.1055/s-0034-1370346 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0034-1370346 ER -