How Long Can Umbilical Venous Catheters Be Used?

What does an umbilical venous catheter do?

In most cases, after birth, an umbilical venous catheter (UVC) is used during the first 3-7 days or less. Sometimes, it may remain in place until the baby is 2 weeks old. If the baby still needs a catheter after it is removed, the doctor will assess which type of a catheter is the most appropriate for the subsequent use. The choice of an intravenous catheter depends on the baby’s needs.

A UVC is the preferred method of vein access in the neonatal intensive care unit (NICU). However, it can only be inserted into a newborn who is around 2 weeks old. After 2 weeks, the umbilical cord and veins leading from the UVC to body naturally obliterate and disappear. The UVC can be placed quickly, remain in place for up to 2 weeks if necessary, and accommodate a larger size catheter.

Explanation:

• The umbilical cord is made up of a jelly-like substance with three blood vessels (one vein and two arteries). In the womb, the baby exchanges blood, oxygen, and nutrients with the mother’s placenta through the blood vessels in the umbilical cord.
• These vessels shrivel up after birth but can be used for placing an umbilical catheter during the first week of life.
• A UVC is inserted into the vein. If it is inserted through the artery, it is called an umbilical arterial catheter (UAC).
• These catheters do not cause any pain to the baby. Unlike other parts of the body, there are no nerves in the umbilical cord to transmit pain signals.

Reasons:

• A UVC is used to give necessary intravenous fluids and medications.
• A UAC is used to draw blood for tests without causing pain and monitor blood pressure without disturbing the baby.
• Babies born premature, who are extremely sick, and who are in shock need many blood tests, medications, and concentrated intravenous nutrition fluid to be given directly into their bloodstream. In these cases, a UVC is helpful.
• Since the blood vessels in the arms and legs of premature or extremely sick babies are tiny and hard to see, a UVC is usually considered.

Procedure:

• The doctor inserts catheters using a sterile procedure to prevent infection.
• The doctor or nurse wears a mask, a sterile gown, and sterile gloves before the procedure. They carefully clean the umbilical cord and skin around it with an antiseptic solution.
• They place a soft, thin tube called a catheter through the blood vessels (one through one of the arteries and one through the vein) in the umbilical cord into large blood vessels in the body.
• They secure the catheters in place with special bandages.
• After the procedure, they take an X-ray to make sure the catheters are in the right place. Sometimes, they may need to adjust the position of the catheter.

Possible complications:

A catheter in the wrong position may be adjusted if possible. Otherwise it may have to be removed. Catheter placement may rarely cause the following:

• Damage to the liver
• Infection
• Blood clots that block the blood vessel
• Bleeding
• Irritation of the blood vessels causing decreased circulation to parts of the body
• The fluid to leak into the chest or abdominal cavity requiring further treatments
• The catheter to break when removed