Incidence of complications following umbilical vein catheterisation in neonates

Kannan Chinnaswamy, Anandhi Chandramohan, Karthikeyan Kadirvel, Soundararajan Palanisamy


Background: Umbilical vein catheter (UVC) insertion in newborns has life threatening complications like Catheter related bloodstream infections (CRBSI), Portal vein thrombosis (PVT) and other mild complications. This study has been done to assess the incidence and risk factors of complications in neonates with umbilical vein catheterisation.

Methods: A prospective observational study was carried out in neonates admitted to a South Indian tertiary care hospital between January 2017- June 2018.

Results: Umbilical vein catheterisation was done for 65 neonates, of them 46 completed the study. One neonate (2%) developed CRBSI and none of them developed PVT in both baseline and follow up scans. Minor complications noted were repositioning in 26%, umbilical site leak in 23%, reattempts in 19%, catheter block in 13%, periumbilical erythema in 6% and umbilical site bleed in 2%. There was no statistical significance between minor complications and baseline study characteristics.

Conclusions: Although UVC is a common and easy vascular access, it is not without complications. Incidence of serious complications following umbilical vein catheterisation is low when proper technique and sterile precautions are followed. However, the occurrence of mild complications following UVC insertion is high.


Catheter related bloodstream infections, Portal vein thrombosis, Repositioning, Umbilical vein catheterisation, Umbilical vein catheter

Full Text:



Sengupta A, Lehmann C, Diener-West M, Perl TM, Milstone AM. Catheter duration and risk of CLA-BSI in neonates with PICCs. Pediatrics. 2010;125(4):648-53.

Willams S, Chan AK. Neonatal portal vein thrombosis: Diagnosis and management. Semin Fetal Neonatal Med. 2011;16:329-39.

Dunn PM. Localization of the umbilical catheter by post-mortem measurement. Arch Dis Child 1966;41:69-75.

Verheij GH, Te Pas AB, Witlox RS, Smits-Wintjens VE, Walther FJ, Lopriore E. Poor accuracy of methods currently used to determine umbilical catheter insertion length. Int J Pediatr 2010;2010:873167.

Mutlu M, Aslan Y, Kul S, Yılmaz G. Umbilical venous catheter complications in newborns: a 6-year single-center experience. J Matern Fetal Neonatal Med. 2016;29(17):2817-22.

Narang S, Roy J, Stevens TP, Butler-O’Hara M, Mullen CA, D’Angio CT. Risk Factors for Umbilical Venous Catheter-Associated Thrombosis in Very Low Birth Weight Infants. Pediatr Blood Cancer. 2009;52(1):75-9.

Grizelj R, Vukovic J, Bojanic K, Loncarevic D, Stern-Padovan R, Filipovic-Grcic B, et al. Severe liver injury while using umbilical venous catheter: case series and literature review. Am J Perinatol. 2014;31(11):965-74.

Hollingsworth C, Clarke P, Sharma A, Upton M. National survey of umbilical venous catheterisation practices in the wake of two deaths. Arch. Dis. Child. Fetal Neonatal Ed. 2015;100(4):371-2.

Shareena I, Khu YS, Cheah FC. Intraperitoneal extravasation of total parental nutrition infusate from an umbilical venous catheter. Singapore Med J. 2008;49(2):35-6.

Kim JH, Lee YS, Kim SH, Lee SK, Lim MK, Kim HS. Does umbilical vein catheterization lead to portal venous thrombosis? Prospective US evaluation in 100 neonates. Radiology. 2001;219(3):645-50.

O’Grady NP, Alexander M, Dellinger EP, Gerberding JL, Heard SO, Maki DG, et al. Guidelines for the prevention of intravascular catheter-related infections. MMWR Recomm Rep. 2002;51:1-29.

Butler-O’Hara M, D’Angio CT, Hoey H, Stevens TP. An evidence-based catheter bundle alters central venous catheter strategy in newborn infants. J Pediatr. 2012;160(6):972-7.

Schulman J, Stricof R, Stevens TP, Horgan M, Gase K, Holzman IR, et al. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics. 2011;127(3):436-44.

Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;49(1):1-45.