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A potential complication of percutaneously inserted central venous catheters (PCVCs) is inadvertent lodgement in an ascending lumbar vein (ALV; figure 1). Associated morbidities include epidural extravasation of parenteral nutrition, seizures, quadriplegia and death.1 The incidence of ALV catheter malposition is unknown. We aimed to (1) determine the incidence of ALV catheter malposition in our neonatal intensive care unit (NICU) and (2) survey current UK practices regarding use of radiopaque contrast for checking PCVC position.
We routinely inject radiopaque contrast medium (0.2–0.3 mL of Omnipaque 300 mg iodine/mL; GE Healthcare) to verify PCVC position and record details of all PCVCs inserted into a bespoke electronic database. We interrogated this database for cases of suspected ALV malposition and cross-referenced with a separate, prospectively maintained list …
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