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Umbilical Venous Catheters

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Vascular Access in Neonates and Children

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Abstract

The umbilical venous catheter (UVC) is an extremely common vascular access device in neonates of any gestational age, given the immediate accessibility of the umbilical vein and the relative simplicity of its placement. UVC presents peculiar characteristics that one must keep in mind to optimize its use. First, the tip of the UVC must be placed at the entrance of right atrium, at the junction between atrium and inferior vena cava. This position is considered to be safe and associated with minimal incidence of complications. In some emergency situations a sub-hepatic position has also been regarded as clinically acceptable (so-called ‘umbilical venous sub-hepatic catheter’, UVSHC). Noteworthily, UVC is a central venous access device, since the tip is located in the right atrium or in the inferior vena cava, while UVSHC should be regarded as a peripheral venous access. Also, the ‘sub-hepatic’ position is associated with severe thrombotic and infective complications and should be adopted only as an emergency: UVSHC should be replaced as soon as possible. The different indications of UVC and UVSHC are described in Table 10.1.

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Authors and Affiliations

  1. Division of Pediatrics and Neonatal Critical Care, Medical Centre “A.Béclère”, South Paris University Hospital, APHP and South Paris-Saclay University, Paris, France

    Roberta Centorrino, Valentina Dell’Orto & Daniele De Luca

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  1. Roberta Centorrino
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  2. Valentina Dell’Orto
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  3. Daniele De Luca
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  1. Intensive Care Unit, Department of Emergency, Anesthesiology and Intensive Care, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy

    Daniele G. Biasucci

  2. Head of Research and Innovation Unit, Department of Anesthesia, Istituto Giannina Gaslini, Genova, Italy

    Nicola Massimo Disma

  3. Department of Surgery, Catholic University Hospital, Rome, Italy

    Mauro Pittiruti

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Centorrino, R., Dell’Orto, V., De Luca, D. (2022). Umbilical Venous Catheters. In: Biasucci, D.G., Disma, N.M., Pittiruti, M. (eds) Vascular Access in Neonates and Children. Springer, Cham. https://doi.org/10.1007/978-3-030-94709-5_10

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