UVCs and Liver Abscesses

UVCs and Liver Abscesses

Hepatic abscesses associated with umbilical catheterization in two neonates. Moens E, De Dooy J, Jansens H, et al. Eur J Pediatr (2003) 162: 406-9.

Abstract: We describe two neonates with a liver abscess after umbilical venous catheterization. The first case was a female neonate, born at 32 weeks of gestation. After persistence of elevated inflammatory parameters, an abscess in the right lobe of the liver was diagnosed. Percutaneous drainage under CT guidance was performed. The aspirated pus grew Staphylococcus epidermidis. Inflammatory parameters normalized after 27 days of antimicrobial therapy (vancomycin, cefotaxime, rifampicin). The second case was in a male neonate, born at 29 weeks of gestation. Percutaneously aspirated pus from the liver abscess was cultured and remained sterile. The patient received antimicrobial therapy (vancomycin, cefotaxime, amikacin) for 26 days and was cured with conservative treatment.

Conclusion: hepatic abscess should be considered in any infant with an umbilical catheter-associated sepsis and persistent inflammatory response in spite of adequate antimicrobial therapy, especially when signs of abdominal infection are present.

Comment: Liver Abscess is an uncommon but serious complication of UVCs. This gives us yet another reason to replace the UVCs with PICC lines as soon as feasible. ABK.

Date: 19 Jun 2003
Time: 09:42:16

I was very interesting to know that liver abcess is one of the complications of UVC.
I would like to share with you my experience regarding one of the rare but recognized complications of UVC.
I had one patient 27 weeker,who had Moderate HMD. UVC was inserted the tip level was high in the pulmonary vein though FOV , the uvc was pulled by 4-5 cm but the patient went off suddenly in the form of bradycardia, hypotension and desaturation, advanced resuscetation was commenced but the pateint didn't respond ,unfortunately died,,,,,NB: no post mortem investigation was done ,,,,,
I went through literature ,I have found few cases almost with the same scenario,,,,The conclusion was perforation of pulmonary vessel leading to cardiac tamponade or irritation of SA-node followed by sudden arrhythmia and cardiac arrest.....
I believe we will continue seeing these rare fatal complications until the debate of the position of UVC in Right Atrium or SVC is solved .....

UserName: Dr.Hesham AL-Girim,MD
Institution: KAAH,NATIONAL GUARD,KSA
telephone:   0096635910000
email:    hgirim@health.net.sa

Date: 22 Jun 2003
Time: 10:11:21

With regard to the comment - UVC's out PICC lines in - lets not forget that PICC lines have their "own" complications which those of us using it should be aware of..

UserName: Yoram Bental M.D.
Institution: Sanz Medical Center, Laniado Hospital
email: yabental@laniado.org.il

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