Complicacions related to vascular cannulation

Insertion of both umbilical arterial catheter and umbilical venous catheter is routinely performed after birth or several days after in the neonate. Umbilical venous catheter is preferred when immediate vascular access is required. Cannulation of umbilical vein has more frequent complications. Catheters are also insterted into subclavian vein. With use of vascular cannulation there is a general risk of accidental dislogement, hemorrhage, endothelial trauma and associated thrombosis, thrombemboli and infection by bacteria and fungi colonizing the lines. Otherwise a small trombus adherent to the tip of the catheter is quite common as well as small mural thrombi.

More serious complications are:

• Umbilical artery  —  massive aortic thrombosis, mesenteric, renal and limb arteries thrombosis resulting in visceral infarction or necrotizing enterocolitis, lower limb and perineum gangrene, gangrene of toes with thrombemboli, vasospasm, hematuria, renal insufficiency, transient increse in blood pressure
• Umbilical vein  —  thrombosis of portal vein branches and hepatic necrosis, portal hypertension
• Systemic veins  —  catheter related infecions and central sepsis, vena cava obstruction, cardia arrythmias, pleural and pericardial effusiont, perforation of myocardium (rare)