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Niger J Clin Pract 2020 Mar;23(3):429-433

Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.

Bleeding oesophageal varices is a rare condition in children and most of them are usually of extrahepatic causes. Neonatal umbilical catheterization even though safe has been identified as a cause of portal vein thrombosis and oesophaeal varices. We report a 9-year old Nigerian girl who had massive upper gastrointestinal bleeding from oesophageal varices secondary to pulmonary vein stenosis. Read More

Pediatr Neonatol 2020 02 7;61(1):1-2. Epub 2020 Jan 7.

Division of Gastroenterology and Nutrition, Department of Pediatrics, MacKay Children's Hospital, No.92, Sec.2, Chung Shan North Road, 10449, Taipei, Taiwan; School of Medicine, MacKay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City, 252, Taiwan. Electronic address:

Cardiovasc Drugs Ther 2019 12;33(6):687-692

Eastern Health Clinical School, Monash University, Clayton, Australia.

Purpose: Drug-eluting balloon catheters (DEBc) coated with paclitaxel (PTX) have been associated with potential safety concerns. An efficacious but less toxic balloon coating may reduce these outcomes. We evaluated a novel DEBc, Epi-Solve, coated with metacept-3 (MCT-3), a member of the histone deacetylase inhibitor (HDACi) class of epigenetic agents, in a large animal model of neointimal hyperplasia (NIH). Read More

Cell Transplant 2019 Dec 17;28(1_suppl):14S-24S. Epub 2019 Dec 17.

Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Hepatocyte transplantation (HcTx) is a promising approach for the treatment of metabolic diseases in newborns and children. The most common application route is the portal vein, which is difficult to access in the newborn. Transfemoral access to the splenic artery for HcTx has been evaluated in adults, with trials suggesting hepatocyte translocation from the spleen to the liver with a reduced risk for thromboembolic complications. Read More

BMJ Case Rep 2019 Dec 3;12(12). Epub 2019 Dec 3.

Neonatology, Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates.

Central venous lines are an essential part of neonatal intensive care and are used for infusion of medications and parenteral nutrition (PN). PN is usually given via either peripherally inserted central lines or umbilical venous lines. Occasionally, central venous catheters (CVCs) are inserted in the femoral veins. Read More

Am J Case Rep 2019 Sep 19;20:1382-1386. Epub 2019 Sep 19.

Department of Neonatology, King Fahd Medical City, Riyadh, Saudi Arabia.

BACKGROUND Umbilical venous catheter (UVC) insertion is a standard of care in neonatal units. Pericardial effusion, one of the rare but fatal complications of UVC insertion, requires rapid diagnosis and management, and saline contrast echocardiography may enable effective diagnosis. Here, we have reported on the case of pericardial effusion after UVC insertion, highlighted the use of saline contrast echocardiography as a diagnostic tool, and reviewed the available literature on this infrequent life-threatening complication. Read More

Arch Dis Child Fetal Neonatal Ed 2020 May 7;105(3):299-303. Epub 2019 Aug 7.

Department of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.

Background: Umbilical venous catheters (UVCs) are associated with thrombus formation. Most studies on thrombosis in infants with UVCs focus on only one part of the route, and none assessed a control group of infants without UVCs.

Objective: To determine the incidence and location of thrombi in infants after umbilical catheterisation and compare this with a control group of infants without umbilical catheters. Read More

Medicina (Kaunas) 2019 Aug 6;55(8). Epub 2019 Aug 6.

NICU, University General Hospital, 41222 Larissa, Greece.

Peripherally inserted central catheters (PICC) and umbilical venous catheters (UVC) are frequently used for vascular access in neonatal intensive care units (NICUs). While there is a significant need for these devices for critically ill neonates, there are many complications associated with their use. We aimed at investigating the incidence of UVC and PICC complications in very low birth weight (VLBW) infants. Read More

Arch Pediatr 2019 Sep 5;26(6):381-384. Epub 2019 Jul 5.

Neonatal Intensive Care Unit of Pontoise, Hospital René-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France.

Fast and safe venous access can be a critical issue in the delivery room during neonatal cardiopulmonary resuscitation or before endotracheal intubation. Here, we describe a new method to inject drugs using the umbilical vein, directly punctured through Wharton's jelly, performed in ten newborns between November 2016 and May 2018. The umbilical vein was identified and punctured easily and a reflux was obtained in all patients. Read More

J Med Microbiol 2019 Sep 5;68(9):1306-1313. Epub 2019 Jul 5.

Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.

Umbilical catheterization offers unique vascular access that is only possible in the neonatal setting due to unobstructed umbilical vessels from foetal circulation. With the cut of the umbilical cord, two arteries and a vein are dissected, allowing quick and painless catheterization of the neonate. Unfortunately, keeping the umbilical access sterile is challenging due to its mobility and necrosis of the umbilical stump, which makes it a perfect model for vessel catheter colonization analysis. Read More

Artif Organs 2019 Dec 28;43(12):1154-1161. Epub 2019 Jul 28.

Center for Fetal Research, Department of Surgery, Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania.

EXTEND (EXTra-uterine Environment for Neonatal Development) is a novel system for supporting extremely premature infants that replicates in utero conditions by maintaining a sterile fluid environment and providing gas exchange via a pumpless arteriovenous oxygenator circuit connected to the umbilical vessels. Target gestational age (GA) for EXTEND support in human infants is 23-27 weeks, when immature lungs are most susceptible to injury in the setting of air ventilation. We previously demonstrated physiologic support of premature lambs cannulated at 105-117 days GA (lungs developmentally analogous to the 23-27 week GA human infant) for up to 28 days on EXTEND. Read More

Pediatr Neonatol 2020 02 18;61(1):16-24. Epub 2019 May 18.

Division of Neonatology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Taoyuan, 33305, Taiwan; Chang Gung University College of Medicine, 259, Wenhua 1st Rd., Taoyuan City 33302, Taiwan.

Background: Care of newborns in the neonatal intensive care unit generally involves umbilical venous catheterization (UVC) for central vein access to enable medical needs. The study aimed to evaluate the sonographic appearance, risk factors, and outcomes of UVC-related hepatic extravasation (HE) in neonates.

Methods: A 5-year retrospective study where 33 neonates were enrolled with a diagnosis age ranging from 2 to 25 days. Read More

An Pediatr (Barc) 2020 Apr 22;92(4):215-221. Epub 2019 May 22.

Servicio de Neonatología, Departamento de Pediatría, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo León, México.

Introduction: Although the use of ultrasound for the insertion of central catheters has proven to be cost-effective in adults, it is not known if this is the case in the neonatal population. This study compared the cost-effectiveness of ultrasound-guided umbilical venous catheterisation with conventional catheterisation in a neonatal intensive care unit of a Public University Hospital.

Patients And Methods: A retrospective observational study was conducted on newborns that required an umbilical venous catheter before completing their first 24hours of extra-uterine life. Read More

Saudi J Anaesth 2019 Apr-Jun;13(2):153-154

Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttrakhand, India.

Indian Pediatr 2019 Mar;56(3):199-201

Department of Pediatrics, JSS Medical college Hospital, JSS University, MG Road, Mysuru. Karnataka, India.

Objective: To compare the rate of optimal position of UVC between modified Shukla's formula and JSS formula.

Methods: Babies requiring umbilical vein catheterization were randomized to either Shukla or JSS formula group. Post-procedure X-ray was taken to check the tip position. Read More

Pediatr Cardiol 2019 04 30;40(4):878-879. Epub 2019 Mar 30.

Department of Paediatric Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Dig Liver Dis 2019 08 6;51(8):1179-1184. Epub 2019 Mar 6.

Paediatric Liver, GI and Transplantation, Hospital Papa Giovanni XXIII Bergamo, Bergamo, Italy. Electronic address:

Objectives: Non-cirrhotic portal vein thrombosis (PVT) is a main cause of portal hypertension in children. We describe the characteristics at presentation and outcome of a cohort of patients with PVT to determine clinical features and predictors of outcome.

Methods: We recorded: (1) Associated factors: prematurity, congenital malformations, neonatal illnesses, umbilical vein catheterization (UVC), deep infections, surgery; (2) congenital and acquired prothrombotic disorders; (3) features at last follow up including survival rate and need for surgery. Read More

Br J Hosp Med (Lond) 2019 Mar;80(3)

Consultant Paediatric Surgeon and Urologist, Department of Paediatric Surgery, Bristol Royal Children's Hospital, Bristol BS2 8BJ.

Indian Pediatr 2019 02;56(2):149

Department of Neonatology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.

Neonatology 2019 15;115(3):205-210. Epub 2019 Jan 15.

Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.

Background: Migration of umbilical venous catheters (UVCs) has been described anecdotally.

Objectives: The aim of this paper was to investigate migration of UVCs using ultrasonography (US).

Methods: In a prospective observational study, the position of UVCs was determined using serial US within 24 h, at midweek, and at the end of the week after umbilical catheterization. Read More

Early Hum Dev 2019 01 10;128:12-14. Epub 2018 Nov 10.

Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK; MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre Based at Guy's and St. Thomas' NHS Foundation Trust and King's College London, UK.

We reviewed the radiographs of 131 infants with congenital diaphragmatic hernia and report that the umbilical venous catheter usually deviates to the ipsilateral and the endotracheal tube to the contralateral side of the defect. The trachea and the umbilical vein, however, can be found on either side of the midline. Read More

J Pediatr Gastroenterol Nutr 2019 03;68(3):384-388

Department of Surgery, University of Minnesota, Masonic Children's Hospital, Minneapolis, MN.

Purpose: Extrahepatic portal vein obstruction (EHPVO) is the most frequent cause of portal hypertension in children. Some patients are not amenable to meso-Rex bypass and alternative surgeries do not restore physiologic flow. We aim to demonstrate the feasibility and safety of minilaparotomy for recanalization of chronic EHPVO. Read More

Turk J Pediatr 2018 ;60(2):191-193

Division of Pediatric Cardiology, Departmant of Pediatrics, Dicle University Faculty of Medicine, Diyarbakır, Turkey.

Akın A, Bilici M, Demir F, Yılmazer MM, İpek MŞ, Kara H. Percutaneous retrieval of umbilical vein catheter fragment in an infant two months after embolization. Turk J Pediatr 2018; 60: 191-193. Read More

Arch Dis Child Fetal Neonatal Ed 2019 May 29;104(3):F326. Epub 2018 Sep 29.

Department of Neonatology, Sunderland Royal Hospital, Sunderland, UK.

Arch Dis Child Educ Pract Ed 2019 Apr 13;104(2):88-96. Epub 2018 Aug 13.

Department of Neonatology, University College London Hospital, London, UK.

Turk J Pediatr 2018 ;60(1):113-115

Departments of Interventional Radiology, Başkent University Faculty of Medicine, Ankara, Turkey.

Varan B, Yakut K, Harman A. Transcatheter retrieval of embolized catheter using venovenous loop in a neonate. Turk J Pediatr 2018; 60: 113-115. Read More

J Perinatol 2018 10 6;38(10):1359-1364. Epub 2018 Aug 6.

Department of Pediatric Radiology, Clocheville Hospital, CHRU, 49 Boulevard Beranger, Tours, France.

Objective: The aim of the study was to better describe incidence, risk factors, and the natural evolution of neonatal portal vein thrombosis (PVT).

Study Design: One hundred and twenty-three premature newborns or with birth weight <1.5 kg were prospectively included in a single center during a one-year period. Read More

Dis Model Mech 2018 06 22;11(6). Epub 2018 Jun 22.

Reference and Translation Center for Cardiac Stem Cell Therapy, Rostock University Medical Center, 18055 Rostock, Germany.

Ischemic heart failure is the leading cause of mortality worldwide. An early boost of intracardiac regenerative key mechanisms and angiogenetic niche signaling in cardiac mesenchymal stem cells (MSCs) could improve myocardial infarction (MI) healing. Epicardial erythropoietin (EPO; 300 U kg) was compared with intraperitoneal and intramyocardial EPO treatments after acute MI in rats (=156). Read More

Acta Paediatr 2018 08 17;107(8):1469-1470. Epub 2018 May 17.

Department of Neonatology, The National Maternity Hospital, Dublin 2, Ireland.

Radiology 2018 05;287(2):719-724

From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110.

History A 3-month-old previously healthy girl presented to an outside institution with a 4-day history of low-grade fever, irritability, and a tender "knot" in the upper abdomen. Ultrasonography (US) was performed at an outside hospital. US images were not available for review; however, they showed a mass in the left hepatic lobe, per the outside report, and the patient was referred to our institution for further evaluation. Read More

BMJ Case Rep 2018 Apr 17;2018. Epub 2018 Apr 17.

Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. Read More

Arterioscler Thromb Vasc Biol 2018 06 5;38(6):1368-1380. Epub 2018 Apr 5.

From the Center for Hemostasis and Thrombosis Research, Tufts Medical Center, Tufts University School of Medicine, Boston, MA (R.R., T.H., G.K., E.K.F., S.E.T., A.S., L.C., A.K.)

Objective: Protease-activated receptor-1 (PAR1) is classically activated by thrombin and is critical in controlling the balance of hemostasis and thrombosis. More recently, it has been shown that noncanonical activation of PAR1 by matrix metalloprotease-1 (MMP1) contributes to arterial thrombosis. However, the role of PAR1 in long-term development of atherosclerosis is unknown, regardless of the protease agonist. Read More

Int J Artif Organs 2018 Jul 22;41(7):393-399. Epub 2018 Mar 22.

1 Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada.

Introduction: A lung assist device, which acts as an artificial placenta, can provide additional gas exchange for preterm and term newborns with respiratory failure. The concept of the lung assist device requires a large bore access via umbilical vessels to allow pumpless extracorporeal blood flow rates up to 30 mL/kg/min. After birth, constricted umbilical vessels need to be reopened for vascular access. Read More

Arch Dis Child Fetal Neonatal Ed 2019 Mar 17;104(2):F165-F169. Epub 2018 Mar 17.

Newborn Research Centre, The Royal Women's Hospital, Parkville, Victoria, Australia.

Introduction: Umbilical venous catheter (UVC) placement is a common neonatal procedure. It is important to position the UVC tip accurately at the first attempt to prevent complications and minimise handling. Catheters positioned too low need to be removed, but catheters positioned too high may be withdrawn in a sterile fashion to a safe position. Read More

Pediatr Crit Care Med 2018 05;19(5):468-476

Pediatric Working Group, Austrian Resuscitation Council, Graz, Austria.

Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation.

Design: Retrospective analysis of audio-video recorded neonatal simulation training.

Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Read More

Pediatr Crit Care Med 2018 04;19(4):332-338

Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta Health Services, Canada.

Objective: During neonatal cardiopulmonary resuscitation, early establishment of vascular access is crucial. We aimed to review current evidence regarding different routes for the administration of medications during neonatal resuscitation.

Data Sources: We reviewed PubMed, EMBASE, and Google Scholar using MeSH terms "catheterization," "umbilical cord," "delivery room," "catecholamine," "resuscitation," "simulation," "newborn," "infant," "intraosseous," "umbilical vein catheter," "access," "intubation," and "endotracheal. Read More

J Physiol 2018 05 2;596(9):1575-1585. Epub 2018 Mar 2.

Center for Fetal Research, Department of Surgery.

Key Points: Bronchopulmonary dysplasia is a disease of extreme prematurity that occurs when the immature lung is exposed to gas ventilation. We designed a novel 'artificial womb' system for supporting extreme premature lambs (called EXTEND) that obviates gas ventilation by providing oxygen via a pumpless arteriovenous circuit with the lamb submerged in sterile artificial amniotic fluid. In the present study, we compare different arteriovenous cannulation strategies on EXTEND, including carotid artery/jugular vein (CA/JV), carotid artery/umbilical vein (CA/UV) and umbilical artery/umbilical vein (UA/UV). Read More

J Biomed Nanotechnol 2016 Dec;12(12):2185-01

The aim of this study was to investigate the anti-inflammatory effects and mechanism of action of the gold nanoparticles (AuNPs) on vascular injury. In vitro vascular endothelial cell (EC) inflammation and in vivo rat carotid balloon injury models were used. The expression of TNF-α-induced cell adhesion molecules (CAMs) was suppressed by the AuNPs in human umbilical vein ECs and aortic ECs. Read More

J Vasc Surg Cases Innov Tech 2017 Dec 2;3(4):218-220. Epub 2017 Nov 2.

Section of Pediatric Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn.

A 43-day-old boy presented with bacteremia after umbilical artery catheterization. Duplex ultrasound examination revealed a 1.1- × 1. Read More

Resuscitation 2018 Jan 26;122:e21-e22. Epub 2017 Nov 26.

Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

Front Pediatr 2017 5;5:211. Epub 2017 Oct 5.

Pediatric and Neonatal Intensive Care Unit, Paris South University Hospitals, Le Kremlin-Bicêtre, Assistance Publique Hôpitaux de Paris, Paris, France.

The correct choice of intra vascular access in critically ill neonates should be individualized depending on the type and duration of therapy, gestational and chronological age, weight and/or size, diagnosis, clinical status, and venous system patency. Accordingly, there is an ongoing demand for optimization of catheterization. Recently, the use of ultrasound (US)-guided cannulation of the subclavian vein (SCV) has been described in children and neonates. Read More

Clin Anat 2018 Mar 31;31(2):269-274. Epub 2017 Oct 31.

Institute of Anatomy II, University of Cologne, Cologne, 50926, Germany.

Umbilical cord catheters (UCC) are important for the primary care of critically ill newborns. To analyze anatomical variations of the umbilical vein (UV) and its further course, we performed abdominal spiral-CT examinations on stillborns. The aim of the study was to explore the high incidence of mal-positioned UCCs and to improve their positioning. Read More

J Ultrasound Med 2018 Jun 16;37(6):1335-1344. Epub 2017 Oct 16.

Departments of Neonatology, Gazi University Faculty of Medicine, Ankara, Turkey.

Objectives: Umbilical venous catheterization is commonly used in the neonatal period; however, it has some complications. In this study, we evaluated neonates who underwent umbilical venous catheterization and developed hepatic complications. Furthermore, we aimed to define all of the possible lesions and to clarify the imaging findings of umbilical venous catheter-induced hepatic injury. Read More

Cochrane Database Syst Rev 2017 10 10;10:CD012142. Epub 2017 Oct 10.

Neonatology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, NSW, Australia, 2050.

Background: Lengthy duration of use may be a risk factor for umbilical venous catheter-associated bloodstream infection in newborn infants. Early planned removal of umbilical venous catheters (UVCs) is recommended to reduce the incidence of infection and associated morbidity and mortality.

Objectives: To compare the effectiveness of early planned removal of UVCs (up to two weeks after insertion) versus an expectant approach or a longer fixed duration in preventing bloodstream infection and other complications in newborn infants. Read More

J Pediatr Hematol Oncol 2018 03;40(2):e64-e68

Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden.

Central venous catheters (CVCs) in neonates are associated with an increased risk of thrombosis. Most reports focus on umbilical venous catheters (UVCs) and peripherally inserted central catheters (PICCs), whereas data available on femoral venous catheters (FVCs) are limited. We performed a retrospective cohort study in all neonates (gestational age ≥34 wk) with CVCs. Read More

Am J Perinatol 2018 Feb 14;35(3):233-241. Epub 2017 Sep 14.

Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.

Objective:  The objective of this study was to examine the association between umbilical catheters and a composite outcome of mortality or major neonatal morbidity in extremely preterm infants.

Study Design:  Data were abstracted from the Canadian Neonatal Network database for infants born at <29 weeks' gestational age and admitted to 29 neonatal intensive care units between January 2010 and December 2012. Four groups were identified: those with no umbilical catheters, umbilical venous catheters (UVCs), umbilical artery catheters (UACs), and those with both UVCs and UACs. Read More

Am Surg 2017 Sep;83(9):e364-e366

Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.

Fetal Diagn Ther 2018 11;43(1):77-80. Epub 2017 Aug 11.

Department of Obstetrics and Gynaecology, Sarawak General Hospital, Kuching, Malaysia.

We illustrate a case of giant placental chorioangioma presenting at 20 weeks of gestation. Subsequent monitoring revealed enlargement of the lesion, associated with fetal anemia and cardiac failure, prompting in utero intervention. Amnioreduction followed by percutaneous embolization of the tumour with enbucrilate:Lipiodol Ultra-Fluid™ at a dilution of 1:5 was successfully performed. Read More

Pol J Radiol 2017 16;82:320-321. Epub 2017 Jun 16.

Department of Radiology, Gazi University, Faculty of Medicine, Ankara, Turkey.

Background: Absent ductus venosus (ADV) is a rare condition, but it should be known that this embryonic anomaly may be detected by fetal echocardiographic or newborn ultrasound examinations.

Case Report: We present a baby with an ADV and an accompanying alternative porto-caval shunt between the right portal vein and inferior vena cava detected on postnatal ultrasound examination.

Conclusions: Variations in the fetal umbilical or porto-systemic circulations should be detected by fetal or newborn ultrasound examinations and kept in mind before common interventions such as UV catheterizations. Read More