There is only 1 umbilical vein, and it remains a viable option for cannulation up to 1 week after birth. The umbilical vein carries oxygenated blood from the placenta to the fetus. The UVC passes into the umbilical vein through the umbilicus and follows this path: junction of the right and left portal vein in the liver, across the ductus venosus, across the level of the right and left hepatic vein, and into the inferior vena cava (IVC) to the junction of the IVC and right atrium.
In an emergency postnatal situation (eg, delivery room), a UVC can be rapidly inserted until blood return is obtained (usually 2–4 cm in a term infant; some sources insert 5 cm plus cord length with less distance in preterm) as emergency venous access. Resuscitation medications, volume, and blood can be given.
Single- versus multiple-lumen catheters. Cochrane review (2005) makes no recommendation on using single- versus multiple-lumen catheters. Double-lumen catheters decreased the number of additional venous lines during the first week of life, but they broke, leaked, and clogged more (smaller diameter). No differences in UVC placement difficulty, misplacement, catheter-related infections or blood clots, or rate of infant mortality were noted. Consider using the least number of lumens required.
Suspect cardiac tamponade in ...