A previously undescribed etiology for oliguria in a premature infant with a peripherally inserted central catheter.
Peripherally inserted central catheter use has become widespread in the management of premature infants as a means to provide long-term intravenous therapy and nutritional support until enteral feedings can be established. Peripherally inserted central catheters are not without complications. This article describes the case of a premature infant with oliguria with the suspected etiology of a malpositioned catheter tip at a location where it was either occluding/blocking the renal vein(s) or causing damage to the kidney(s) from administration of hypertonic total parenteral nutrition solution directly into the renal vein(s). Peripherally inserted central catheter position should be verified radiographically and evaluated serially in any infant, even more so in an infant with symptoms of oliguria and possible sepsis.
Wolfe
Desi M
DM
Neonatology, Wake Medical Center, 3000 New Bern Avenue, Raleigh, NC 27610, USA. dwolfe@wakemed.org
D001458:Bandages; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000451:nursing; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation / Q000451:nursing; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D003937:Diagnosis, Differential; D004868:Equipment Failure; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D017283:Neonatal Nursing; D009846:Oliguria / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D010289:Parenteral Nutrition, Total / Q000295:instrumentation / Q000451:nursing; D017410:Practice Guidelines as Topic; D011859:Radiography; D012082:Renal Veins