Association between umbilical venous catheter‒related hepatic complications and tip position in neonates: a retrospective ultrasound-based analysis.

Abstract

Background: Umbilical venous catheterization (UVC) is commonly performed in neonates, but improper catheter tip may lead to hepatic complications.

Aim: This study aims to retrospectively analyze the relationship between UVC tip position and the occurrence of hepatic complications, utilizing ultrasound for early detection and characterization of hepatic injury.

Methods: We conducted a retrospective study of 206 preterm neonates who underwent UVC insertion in a NICU from January 2021 to December 2023. All patients with complete post‒UVC insertion abdominal ultrasound follow‒up records were included. According to the UVC tip position, neonates were divided into two groups: the Central Group and the Non-central Group. Within the non-central group, cases with the tip located in the ductus venosus (DV) formed the DV Subgroup. The incidence of hepatic complications, including portal venous gas, portal vein thrombosis, and hepatic parenchymal injury, was compared across these groups.

Results: Hepatic complications were observed in 23 neonates (11.2%, 23/206), including portal venous gas (6.3%), portal vein thrombosis (1.9%), and hepatic parenchymal injury (2.9%). Among these, 9 cases (39.1%) occurred in the Central Group, while 14 cases (60.9%) were in the Non-Central Group, with 8 of these (57.1%) belonging to the DV Subgroup. The Non-Central Group accounted for the majority of complications, including all cases of hepatic parenchymal injury, with a proportion involving the DV Subgroup. These findings suggest an elevated risk of complications associated with non-central catheter tip position.

Conclusion: Non-central catheter tip positions increase the risk of hepatic complications. Regular ultrasound follow-up is crucial for ensuring proper tip position and early complication detection.