• Insertion of Umbilical Catheter

    (Umbilical Line Insertion)

    Definition

    Insertion of an umbilical catheter is the placement of a tube into the arteries or vein of the umbilical stump.
    During pregnancy the umbilical cord is an important part of your baby’s blood flow system. Once your child is born the cord is no longer needed but the blood vessels remain for a few weeks.
    Umbilical Cord
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    The umbilical stump may be used to deliver treatment or take blood samples in newborns. In newborns, the umbilical cord may be a much easier access point than blood vessels in other parts of the body. This is particularly true for premature babies. The umbilical cord is also painless which can make it easier for the baby.
    A catheter may be used to:
    • Remove blood for testing
    • Monitor blood pressure
    • Deliver nutrients or medicine
    • Deliver or exchange blood
    Regular access to the blood with a catheter will cut down on the number of needle sticks your baby will have. It is also available to treat emergency situations.

    Possible Complications

    All procedures have some risk. The doctor will review potential problems, such as:
    • Excess bleeding
    • Infection in the blood
    • Blood clots
    • Blockage of blood flow to internal organs or legs
    • Problems in the intestine such as necrotizing enterocolitis—if blood flow to intestines is blocked
    • Misplacement of catheter
    • Stroke
    • Pulmonary embolism—blood clot in lung
    Talk to your child’s doctor about these risks before the procedure.

    What to Expect

    Prior to Procedure

    Certain measurements will be taken. This will help to determine how far the catheter is passed into the blood vessels. Your child may also be placed on monitors to measure breathing and heart activity.

    Anesthesia

    Anesthesia may not be needed. The umbilical stump does not have pain nerves. Your child will not feel the work on the umbilical stump.

    Description of the Procedure

    Your baby’s stomach and umbilical cord will be cleaned with an antiseptic. The top portion of the stump will have a clamp that was placed right after birth. A cloth will be tied below the clamp, closer to the stomach. The umbilical stump will then be removed just above the tie. The catheter will be inserted into the artery or vein of the stump. A gentle pressure will be used to pass the catheter into the desired locations.
    An x-ray will be done to make sure the catheter is in the right place. The x-ray will also show if there are any immediate complications. Once the placement is confirmed, the catheter will be secured in place with sutures. The umbilical stump may also be taped to the belly make it more secure.

    Immediately After Procedure

    Your baby will be monitored for the development of any complications. This includes watching the legs for any change in color and monitoring breathing and heart rate.

    How Long Will It Take?

    The procedure may take 15-30 minutes

    How Much Will It Hurt?

    Your baby cannot feel pain through the umbilical cord. However, your baby will be monitored for any distress. Medication will be given to ease discomfort.

    Average Hospital Stay

    The length of time that the catheter remains in will depend on your child’s condition. The hospital stay will also be determined by your child’s overall health.

    Post-procedure Care

    At the Hospital
    Your child’s care staff will take steps to prevent infection in the catheter. Steps should include:
    • Washing hands and wearing gloves before touching the catheter.
    • Cleaning the catheter area with an anesthetic.
    • Keeping an eye out for signs of infection.
    • Removing catheter as soon as possible.
    Treatment will be delivered through the catheter as needed.
    At Home
    The catheter will likely be removed before your child goes home. There are no special steps that need to be taken once the catheter is removed.

    Call Your Doctor

    Call your child’s doctor if any of these occur:
    • Signs of infection—fever and chills, redness or swelling at the umbilical area
    • Pain in the umbilical area
    • Pus around the stump
    If you have an emergency, call for medical help right away.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org

    American Academy of Pediatrics http://www.aap.org

    CANADIAN RESOURCES

    AboutKidsHealth http://www.aboutkidshealth.ca

    Canadian Family Physician http://www.cfpc.ca

    References

    Insertion of umbilical vessel catheters. University of Iowa Children’s Hospital website. Available at: http://www.uichildrens.org/childrens-content.aspx?id=234448 . Accessed December 17, 2012.

    Neonatal umbilical vessel catheterrization. University of California San Francisco Medical Center website. Available at: http://www.ucsfmedicalcenter.org/medstaffoffice/Standardized%5FProcedures/Neonatal%20Umbilical%20Vessel%20Catheterization.pdf . Accessed December 17, 2012.

    Umbilical venous catheterisation. Health Sydney Local Health District website. Available at: http://www.sswahs.nsw.gov.au . Accessed December 17, 2012.

    Revision Information

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