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Bajaber A, Ali MH, Bazuhair AO, Bajaber O, Alsaiady M, Rabie S, BinMahmoud L, Alfaki D. Successful retrieval of deep intracardiac migrated broken umbilical venous catheter in a preterm infant: Case report. Radiol Case Rep 2024; 19:1235-1238. [PMID: 38292783 PMCID: PMC10825532 DOI: 10.1016/j.radcr.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024] Open
Abstract
Umbilical catheters serve as indispensable tools in the realm of neonatal intensive care, contributing significantly to the well-being of premature infants. While rare, it is essential to approach their handling with utmost caution, as it can lead to fatal complications. We report a case of a preterm 9-day-old male infant, who was referred to our center for specialized treatment following an unsuccessful surgical attempt to address a fractured umbilical venous catheter (UVC). This case underscores the value of employing imaging techniques for prompt identification of such complications. Furthermore, the utilization of endovascular therapy emerges as a promising intervention in managing such complexities, thereby expanding the horizons of interventional radiology in elevating the standard of patient care.
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Affiliation(s)
- Abubakr Bajaber
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Magda Hag Ali
- Department of Pediatric Cardiology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Adeeb Omar Bazuhair
- Medical Imaging Department, Interventional Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Omar Bajaber
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Moath Alsaiady
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Samy Rabie
- Department of Pediatric Cardiology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Latifa BinMahmoud
- Neonatal Critical Care Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Doaa Alfaki
- Neonatal Critical Care Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
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Uwaifo OO, Crittendon I, Lucas VS. Percutaneous retrieval of embolized umbilical arterial catheter in extreme premature infant. J Vasc Access 2024:11297298241228613. [PMID: 38342977 DOI: 10.1177/11297298241228613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Umbilical arterial catheterization is a common procedure performed on critically ill neonates, especially those with extreme prematurity. Various complications have been described following umbilical artery catheter (UAC) placement including thrombosis, embolism, vasospasm, vascular perforation, hemorrhage, and infection. However, treatment of these complications is challenging due to the small size of this very fragile subset of patients. METHODS A 3-day old extremely preterm infant was referred to our institution for percutaneous removal of a fragmented and embolized umbilical arterial catheter. RESULTS Catheter retrieval was successful via a carotid approach utilizing techniques from percutaneous closure of PDA in preterm infants and trans-carotid access for PDA stent and aortic interventions. CONCLUSION This case report describes the successful percutaneous retrieval of an embolized UAC fragment in an extremely preterm infant, the smallest documented in literature to date.
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Affiliation(s)
- Omotola Olubusola Uwaifo
- University of Queensland/Ochsner Clinical School, New Orleans, LA, USA
- Section of Neonatology, Ochsner Baptist Hospital, New Orleans, LA, USA
| | - Ivory Crittendon
- Pediatric Interventional Cardiology, Ochsner Hospital for Children, New Orleans, LA, USA
| | - Victor Sam Lucas
- Pediatric Interventional Cardiology, Ochsner Hospital for Children, New Orleans, LA, USA
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Jensen Rahbek LS, Hjortdal A, Rawashdeh YF. Surgical retrieval of transected umbilical vein catheter in an extremely preterm neonate. BMJ Case Rep 2023; 16:e257355. [PMID: 38129078 DOI: 10.1136/bcr-2023-257355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Umbilical catheters are used in the care of critically ill neonates for intravenous treatment. It is generally considered a safe procedure, although complications can occur. Of these, catheter breakage and intravenous migration are rare but potentially life-threatening events. Due to the low frequency of which these events occur, obtaining detailed descriptions of removal techniques can pose a challenge. Here, we describe a case of a broken umbilical vein catheter and the surgical retrieval of the retained fragment. We also present a thorough literature search of cases of broken umbilical catheters and the method by which they were removed.
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Affiliation(s)
| | - Anders Hjortdal
- General Medicine, Aarhus University Department of Clinical Medicine, Aarhus, Denmark
| | - Yazan F Rawashdeh
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
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Rawat J, Singh S, Tyagi N, Pant N. Retrieval of a retained umbilical vein catheter at 6 months. BMJ Case Rep 2023; 16:e254380. [PMID: 37963667 PMCID: PMC10649496 DOI: 10.1136/bcr-2022-254380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Umbilical venous catheterisation is carried out for the care of neonates who have very low birth weight and are critically ill. It is uncommon for catheter fragments to become fractured and retained. Here, we describe a case of a retained fractured umbilical vein catheter in an infant. An endovascular procedure to retrieve a catheter is the usual management option when the catheter has been accidentally cut and has moved proximally into a major vessel or inside the heart. It is rare to need open exploration and retrieval.
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Affiliation(s)
- Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sudhir Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nirpex Tyagi
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitin Pant
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Transcatheter retrieval of embolised fractured peripherally inserted central catheter: a nightmare in very low birth weight preterm neonate. Cardiol Young 2022; 33:806-809. [PMID: 36047467 DOI: 10.1017/s1047951122002761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Peripherally inserted central catheters are commonly used for intravascular access in low birth weight neonates. Here, we describe a case of transcatheter retrieval of an embolised peripherally inserted central catheter line in the right ventricle extending to the left pulmonary artery in a preterm very low birth weight baby. To the best of our knowledge, this is the first case where transcatheter retrieval of embolised peripherally inserted central catheter line has been done from the left pulmonary artery in such a very low birth weight preterm neonate. Although retrieval of foreign body is common in adults and older children, very few case reports have documented successful retrieval of embolised peripherally inserted central catheter line in very low birth weight neonates using interventional techniques. Most of the cases in literature reported retrieval of an indwelling umbilical venous catheter rather than a peripherally inserted central catheter line as in our case. Also, none of these cases had the embolised fragment retrieved from the left pulmonary artery. This approach was technically very challenging as we were taking care of a 5-day old preterm neonate born at 32 weeks of gestation having very low birth weight (1100 g) with features of clinical sepsis, coagulopathy, and embolised catheter fragment extending from right ventricle to left pulmonary artery. The procedure was uneventful without any complication and the catheter was retrieved successfully.
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Zheng X, Geng W, Li G, Jin F, Liu H, Jia S, Hei M. Retrieval of an Intracardiac Cannula Fragment via Femoral Access in a Premature Infant. Neonatology 2021; 118:373-377. [PMID: 34148039 DOI: 10.1159/000515464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/25/2021] [Indexed: 11/19/2022]
Abstract
A preterm infant with birth weight 1,550 g had an intravenous foreign body between the external iliac vein and the common iliac vein, which accidentally happened during peripheral intravascular central catheter insertion by the Seldinger technique. The infant initially received conservative management and close monitoring. Antibiotics were administered 4 weeks to treat culture positive sepsis and meningitis. The infant was clinically stable till the cannula fragment migrated to the heart 34 days later. At that time, his weight was 2,200 g, and he was full fed. The cannula fragment was retrieved by emergency interventional radiology via the right femoral access, with no complications. The infant was discharged at 45 days of age and closely followed up post-discharge. He is currently 6 months old, with normal development. This is the first case of successful percutaneous retrieval of an intracardiac intravenous cannula fragment via femoral access in a premature infant in China.
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Affiliation(s)
- Xu Zheng
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Wenjing Geng
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Geng Li
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Fei Jin
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Hui Liu
- National Center for Children's Health, Beijing, China.,Cardiac Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Shengnan Jia
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
| | - Mingyan Hei
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health, Beijing, China
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Sharpe EL. Innovative Approach to Procedure Skills: A Nurse Practitioner Educator's Response to COVID-19. J Nurs Educ 2020; 59:692-696. [PMID: 33253398 DOI: 10.3928/01484834-20201118-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/12/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The The Neonatal Nurse Practitioner program at The Ohio State University transitioned from a traditional face-to-face program to a distance-enhanced hybrid model providing course content online with campus visits for procedural skills and simulation in 2017. Although the 2020 COVID-19 pandemic necessitated cancellation of all in-person events across the university, the neonatal nurse practitioner students' learning needs remained the same. METHOD The onsite experience was redesigned for virtual delivery. Procedural content was accomplished through student-led small-group collaborative critical thinking activities surrounding procedural complications, and other faculty-led scenario discussions. RESULTS Students collaborated for a Complications Rounds activity (1-day) that promoted learning about procedural skills from a global perspective including safe techniques, monitoring, risks, and troubleshooting complications. CONCLUSION Procedural content can be achieved when in-person learning is not possible. The Complications Rounds approach can mitigate delays or gaps in practical experiences. Examining complications in-depth increases preparedness, promoting greater awareness of harm prevention when these present in future practice. [J Nurs Educ. 2020;59(12):692-696.].
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