Further studies, with larger samples, are necessary to confirm our results. Conclusions: The incidence of complications associated with the use of UVCs and PICCs in VLBW infants did not significantly differ in our study. Eleven UVC tips and no PICC tips were proved colonized ( p = 0.001) following catheter removal. Results: No significant statistical differences were noticed between the 2 study groups with regards to demographic characteristics, causes for catheter removal, catheter indwelling time or the incidence of nosocomial infection. We recorded: Catheter dwell time, the causes of catheter removal, other complications, infections, and catheter tip colonization rates. Seventy-one neonates were recruited and divided into two groups: 34 neonates with PICC and 37 neonates with UVC. Materials and Methods: This is an observational study performed with neonates of the tertiary General Hospital of Piraeus, Greece, during an 18 month-period. We aimed at investigating the incidence of UVC and PICC complications in very low birth weight (VLBW) infants. While there is a significant need for these devices for critically ill neonates, there are many complications associated with their use. Your healthcare provider will work with you and your family to determine what kind of intervention is best.Background and Objective: Peripherally inserted central catheters (PICC) and umbilical venous catheters (UVC) are frequently used for vascular access in neonatal intensive care units (NICUs). The minimally invasive technique is not appropriate for all children. The advantages are smaller, less visible incisions and a quicker recovery period. The minimally invasive approach is accomplished through three small incisions, the size of a grain of rice. The reimplantation can be done either laparoscopically or through a robotic assisted laparoscopic approach. Minimally invasive surgery (MIS) is an option for children older than 6 months. In young babies, the reimplantation is done through a small incision. This surgical procedure involves removing the section of the ureter that is abnormal, reducing it and reconnecting the ureter. The surgical procedure to correct UVJ obstruction is called a ureteral reimplantation. He will then use a small balloon to expand the narrow area and leave a temporary small tube, called a stent, to allow the urine to drain. While your child is asleep, the surgeon will use a laser to open up the obstruction. Your child's surgery will be done under general anesthesia. In select cases, the obstruction can be managed completely endoscopically (without any skin incisions). Around 18 months of age, the ureter is then reimplanted into the bladder. This allows the affected kidney and ureter to decompress. The ureter is surgically brought to the surface of the skin to allow it to drain urine freely into the diaper. In a newborn with massive ureteral dilation or poor renal function, a cutaneous distal ureterostomy may be recommended. In this situation, we will closely follow your child with repeated imaging studies. In some children, an ultrasound may show a significant amount of dilation ( megaureter and hydronephrosis) but the kidney functions and drains well. In situations where the kidney function is compromised, surgery is needed. Our overall goal in treating a UVJ obstruction is to preserve renal function. Your child may need sedation if she is young and might have difficulty tolerating the length of the study, which is typically 40 minutes.Įach year, approximately 50 ureteral reimplantations are done at CHOP. Your child will need an IV and a catheter for this study. Magnetic resonance urography (MRU) creates detailed pictures of the kidneys, ureters and bladder. MRI/MRU: MRI is a radiation-free diagnostic procedure that uses a combination of a large magnet, radiofrequencies and a computer to produce detailed images of the body. Pictures of the kidneys will be taken with a large machine that rotates around your child. The isotope makes it possible to see the kidneys clearly. An intravenous line (IV) is used to inject a special solution called an isotope into your child's veins. MAG III renal scan: This study helps us determine how each kidney is functioning and the degree of blockage. It will enable us to see the degree of hydronephrosis (dilation of the kidney). Renal bladder ultrasound (RBUS): This procedure uses sound waves to outline the kidneys and bladder. Your child may undergo a variety of tests to help confirm his diagnosis and evaluate the extent of his condition.
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