Catheterization of umbilical vein for diagnosis or therapy, newborn
CPT4 code
Name of the Procedure:
Catheterization of Umbilical Vein for Diagnosis or Therapy, Newborn
Summary
This procedure involves inserting a catheter into the umbilical vein of a newborn to diagnose or provide therapy. It allows doctors to deliver medications, fluids, or to draw blood for tests.
Purpose
The procedure addresses various medical conditions in newborns, including the need for fluid administration, medication delivery, or blood sampling. The goal is to provide effective medical management in a safe, controlled manner.
Indications
- Prematurity requiring intensive monitoring and care
- Need for intravenous access for medication or fluid administration
- Blood sampling for diagnostic purposes
- Treatment of certain critical conditions such as sepsis or electrolyte imbalances
Preparation
- No specific fasting required for the newborn
- All necessary diagnostic tests should be performed beforehand, including baseline blood tests
- Parents are usually informed about the procedure and consent is obtained
Procedure Description
- The newborn is placed in a sterile environment.
- The umbilical stump is cleaned and sterilized.
- A sterile catheter is gently inserted into the umbilical vein.
- The catheter is advanced carefully to the specified position.
- Position confirmation is done, often using X-ray.
- Medications or fluids are administered as needed, or blood is drawn for tests.
Tools and Equipment:
- Sterile catheters
- Sterile gloves, gowns, and drapes
- Antiseptic solutions
- IV fluids and medications
- Radiological equipment for position confirmation
Anesthesia or Sedation:
- Local anesthesia is typically not required, but newborns might be given comfort measures including pacifiers or glucose solutions.
Duration
The procedure generally takes about 15 to 30 minutes.
Setting
The procedure is performed in a hospital setting, usually in the neonatal intensive care unit (NICU).
Personnel
- Neonatologist or trained pediatrician
- NICU nurses
- Radiology technicians (if X-ray confirmation is required)
Risks and Complications
Common risks:
- Infection at the insertion site
- Bleeding or hematoma
- Dislodgement of the catheter
- Blood clot formation
Rare complications:
- Damage to blood vessels
- Systemic infection (sepsis)
Benefits
- Prompt and accurate delivery of necessary treatments
- Reliable method for blood sampling
- Relief of symptoms related to the underlying condition
Recovery
- Continuous monitoring of the newborn post-procedure
- Regular assessment of the catheter site for signs of infection or other complications
- Typically, the catheter is removed when no longer needed, and the insertion site heals rapidly.
Alternatives
- Peripheral IV catheter: Less invasive but may require frequent replacements
- Intraosseous access: Used in emergencies but more painful and less ideal for long-term use
Patient Experience
Newborns may experience slight discomfort during and after the procedure, but care teams provide comfort measures. Chances of significant pain are minimal, and pain management strategies include using pacifiers and glucose solutions for soothing.