All issues > Volume 33(11); 1990

Original Article

J Korean Pediatr Soc. 1990;33(11):1503-1509. Published online November 30, 1990.

Clinical Study of Umbilical Vessel Catheterization in Newborn Infants.

Dae Shik Kim¹, Kook In Park¹, Ran Namgung¹, Chul Lee¹, Dong Gwan Han¹

¹Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea

Received: July 18, 1990;  Accepted: September 10, 1990.

Abstract

Umbilical vessel catheterization has become a common procedure in critically ill newborn infants. We studied the usefulness and complications of indwelling umbilical vessel catheters in 164 patients who were admitted to the neonatal intensive care unit of the Department of Pediatrics, Yonsei University Hospital from January 1985 to December 1988. The results were as follows: 1) Their birth weights ranged from 650 to 3,800 gm, and gestational ages from 24 to 42 weeks. The proportions of patients with umbilical artery catheterization (VAC) were 39.6% in infants with very low birth weight, 36.6% in gestational age less than 30 weeks, 31.7% in normal infants with a birth weight more than 2,500 gm, and 21.8% in gestational age more than 37 weeks. In umbilical vein catheterization (UVC) 31.7% of patients had a birth weight of more than 2,500 gm, and 39.7% of patients had a gestational age of more than 37 weeks. 2) The associated diseases with VAC were; hyaline membrane disease (32.7%), perinatal asphyxia (29.7%), sepsis (15.9%); and those with UVC were perinatal asphyxia (33.3%), neonatal hyperbilir- ubinemia、(31.7%＞，and sepsis(15.9%). 3) Clot occlusion was the most common complication of umbilical vessel catheterization and this was shown in 39.6% of patients. There were 15.2% and 6.7% of patients with oozing around the umbilicus and omphalitis respectively. Catheter tip culture was positive in 20.0%. 4) The average duration of umbilical vessel catheter insertion was longer in complicated cases than uncomplicated cases. Complications were observed in 20.6% of patients with less than 24 hours of duration of catheter insertion and 37.2% of patients with 1 to 3 days of duration of catheter insertion. A greater risk of complications was shown with a longer duration of catheter insertion. 5) According to the Dunn method, only 70.3% of VAC and 66.7% of UVC were placed in the corrected position. So, a serious complication can be prevented by taking an X-ray after umbilical vessel catheterization.

Keywords :Umbilical Vessel Catheterization, Dunn method