Sciatic nerve palsy complicating umbilical arterial catheterization

A term newborn infant developed a right sciatic nerve palsy after ischaemic necrosis of the gluteal region following umbilical arterial catheterization. The nerve lesion was believed to be caused by entrapment and compression by scar tissue. Recovery was slow and remained incomplete up to 6 months of age.     

A modified technique for umbilical arterial catheterization

A modified technique for umbilical artery catheterization was assessed in babies in whom conventional method failed or if the cord was dry. Success rate attained with the modified technique was 90% (19/21). This modified technique could provide an easier and faster method for successful umbilical arterial catheterization.     

Persistent hypoglycemia caused by umbilical arterial catheterization

Hypoglycemia as an umbilical artery catheter (UAC) complication is rare. We present a neonate with hyperinsulinemic hypoglycemia due to a high-positioned UAC used inadvertently for parenteral nutrition. The aim of this report is to increase physicians' awareness of the possibility of this rare complication.     

Unusual evolution of a mycotic hypogastric arterial aneurysm after arterial umbilical catheterization

Report of the 7th case in the literature of aneurysm secondary to catheterization of the umbilical artery; total recovery after surgical removal.     

Hemodynamic consequences of umbilical arterial catheterization. Photoplethysmographic study]

The hemodynamic consequences of umbilical arterial infusions in newborns can be registered by photoplethysmography. Thirty-nine children were observed according to the same protocol: it was possible to recognize, on the side of the infusion, without other clinical symptoms, very early but after different times: - in 3 cases, the supression of arteriolar oscillations, back to normal after 24 hours in one case, and after several weeks in 2 cases; - in 2 cases, a transitory increase of arteriolar oscillations; - in 7 cases, an elective decrease of the arteriolar systolic pressure, with unchanged diastolic pressure. In 4/7 cases, it became normal in less than 3 days; - in 3 cases, a decrease in arteriolar systolic and diastolic pressures, during 2 days.     

Thromboatheromatous complications of umbilical arterial catheterization in the newborn period. Clinicopathological study

Severe catheter-related thromboatheromatous lesions were found at necropsy in 33 of 56 infants who had umbilical arterial catheters passed during life. In infants dying within 8 days of insertion of the catheter, varying degrees of thrombosis of the aorta and its major branches were seen. With increasing thrombosis and aging of the thrombus, fatty deposits were seen first within the thrombus, and then in the intima and media. In addition there was evidence of proliferation of medial smooth muscle cells and of disruption of the medial architecture below the thrombus, characterized by the presence of abundant mucopolysaccharide. In infants who survived longer, varying degrees of organization of the thrombus could be traced, leading eventually to raised fibrous plaques with lipid and occasionally calcification. The lesions in the older infants were similar in many respects to experimental thromboatheromatous lesions produced in rabbits, and to some lesions of artheroma occurring spontaneously in humans. A wide variety of embolic phenomena were found, with features suggesting asynchrony of embolic episodes. The presence of thrombotic lesions could not be related to birthweight, Apgar scores at 1 and 5 minutes, age at catheterization, duration of catheterization, underlying disease process, age at death or the presence of hypothermia, acidosis, or anomalies in coagulation tests. There is a need for less hazardous methods of monitoring arterial oxygen tension.     

Thromboatheromatous complications of umbilical arterial catheterization in the newborn period. Clinicopathological study.

Severe catheter-related thromboatheromatous lesions were found at necropsy in 33 of 56 infants who had umbilical arterial catheters passed during life. In infants dying within 8 days of insertion of the catheter, varying degrees of thrombosis of the aorta and its major branches were seen. With increasing thrombosis and aging of the thrombus, fatty deposits were seen first within the thrombus, and then in the intima and media. In addition there was evidence of proliferation of medial smooth muscle cells and of disruption of the medial architecture below the thrombus, characterized by the presence of abundant mucopolysaccharide. In infants who survived longer, varying degrees of organization of the thrombus could be traced, leading eventually to raised fibrous plaques with lipid and occasionally calcification. The lesions in the older infants were similar in many respects to experimental thromboatheromatous lesions produced in rabbits, and to some lesions of artheroma occurring spontaneously in humans. A wide variety of embolic phenomena were found, with features suggesting asynchrony of embolic episodes. The presence of thrombotic lesions could not be related to birthweight, Apgar scores at 1 and 5 minutes, age at catheterization, duration of catheterization, underlying disease process, age at death or the presence of hypothermia, acidosis, or anomalies in coagulation tests. There is a need for less hazardous methods of monitoring arterial oxygen tension.     

脐静脉置管对极低出生体质量儿早期肠道菌群影响

目的研究脐静脉置管对极低出生体质量儿早期肠道菌群的影响。方法选择2019年6月至2020年6月新生儿监护室收治的41例极低出生体质量儿作为研究对象。根据是否进行脐静脉置管,分为脐静脉置管组24例和非脐静脉置管组17例。收集新生儿生后第1、3、7天的粪便样本,应用高通量测序技术对粪便样本中的细菌16S基因全长进行测序,比较两组间各个时间段肠道菌群多样性及相对丰度。结果入选41例新生儿中,男26例、女15例,胎龄30.0(29.3～30.6)周,出生体质量(1.25±0.10)kg。第1天肠道菌群检出率低。第3天,脐静脉置管组和非脐静脉置管组之间shannon指数差异无统计学意义(P0.05),组间各个菌群相对丰度差异无统计学意义(P0.05)。第7天,与非脐静脉置管组相比,脐静脉置管组shannon指数较低,变形菌门相对丰度较大,厚壁菌门及放线菌门相对丰度较小,克雷伯菌属相对丰度较大,双歧杆菌属及肠球菌属相对丰度较小,差异均有统计学意义(P均0.05)。结论脐静脉置管可改变极低出生体质量儿早期肠道菌群的构成,降低肠道菌群多样性。     

Paraplegia complicating umbilical artery catheterization]

Two cases of definitive paraplegia following umbilical artery catheterization are reported. In both patients, the paraplegia can be attributed to a myelomalacia secondary to the thrombosis or embolization of the feeding arteries of the cord. The treatment by fibrinolytic agents was unsuccessful and the only therapeutic approach appears to be a preventive one. This prophylaxis would best be accomplished by limiting the indications and duration of umbilical artery catheterization.     

脐静脉置管在新生儿中的应用

目的:探讨脐静脉置管在新生儿中的应用。方法:连续性选取北京大学第三医院新生儿重症监护病房2007年11月至2019年9月行脐静脉置管的病例,收集临床病历资料,分析脐静脉置管在新生儿中的应用时间、置管相关性血流感染的发生率、病原菌及拔管原因。结果:共入选新生儿835例,其中男435例(52.1%),女400例(47.9%...     

Aortic aneurysm secondary to umbilical artery catheterization

A 14-month-girl presented with an asymptomatic posterior mediastinal mass. She had a history of prematurity, umbilical artery catheterization, and sepsis. The diagnosis of aortic aneurysm was made by dynamic computed tomography. The aneurysm was successfully resected.