Umbilical venous catheterisation: emergency central venous access which saves lives in coarctation of the aorta
- Resource Type
- Authors
- Gerry Hughes; Nele Legge; Amber Seigel; Kathryn Browning Carmo
- Source
- BMJ case reports. 14(11)
- Subject
- Male
Resuscitation
Umbilical Veins
medicine.medical_treatment
Coarctation of the aorta
Aortic Coarctation
chemistry.chemical_compound
Ductus arteriosus
Catheterization, Peripheral
medicine
Intubation
Humans
Prostaglandin E1
Infusions, Intravenous
business.industry
Infant, Newborn
Infant
General Medicine
medicine.disease
Infusions, Intraosseous
Venous access
Catheter
medicine.anatomical_structure
chemistry
Anesthesia
Heart failure
business
- Language
- ISSN
- 1757-790X
We describe a 9-day-old baby with coarctation of the aorta who required urgent resuscitation including intubation and cardiac compressions. Despite the commencement of prostaglandin E1 (PGE1) to reopen the ductus arteriosus via the intraosseous route, postductal saturations remained unrecordable for a further 45 min. Within 3 min of administration of PGE1 via an umbilical venous catheter (UVC), saturations were recordable at 92%. UVC access was the sentinel intervention that irrevocably altered the clinical prognosis. This baby boy has survived with excellent neurodevelopmental outcome. Clinicians are less familiar with UVCs outside of the newborn period. Our data demonstrate successful placement in neonates up to 28 days of age. We hope this case encourages clinicians to consider the UVC as first-line central venous access in collapsed neonates. In cases of suspected left heart obstruction, we argue that UVCs are the optimal route.