Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore.
National University Singapore Yong Loo Lin School of Medicine, Singapore.
J Paediatr Child Health. 2021 Jul;57(7):1123-1126. doi: 10.1111/jpc.15137. Epub 2020 Sep 9.
Umbilical venous catheter insertion is a common procedure in the neonatal units performed for rapid vascular access. Though relatively safe and easy to perform, suboptimal position of the catheter tip is frequently encountered and can lead to wide range of complications from venous thrombosis, catheter extravasation with extravasation of infusate to intraperitoneal or intrapericardial space, liver injury and cardiac arrhythmias. Identification of catheter extravasation may be difficult and often confused with catheter related infection or necrotising enterocolitis. We present a series of three cases of intraperitoneal extravasation of umbilical venous catheter in the premature neonate with widely varying presentation from subtle biochemical changes to critical clinical signs with rapid and progressive deterioration.
脐静脉导管插入术是新生儿病房中常见的一种操作，目的是快速建立血管通路。虽然该操作相对安全且易于进行，但导管尖端的位置不理想的情况经常发生，可导致从静脉血栓形成、导管外渗导致输注液渗出至腹腔或心包腔、肝损伤和心律失常等广泛的并发症。导管外渗的识别可能较为困难，并且常常与导管相关性感染或坏死性小肠结肠炎相混淆。我们介绍了 3 例早产儿脐静脉导管腹腔内外渗的病例，其临床表现差异很大，从微妙的生化变化到快速进行性恶化的危急临床征象。
