When the course deviates from expected: Misplacement of an epicutaneo-caval catheter in a neonate

Central venous access, a common and essential component of the care of the critically ill neonate, is associated with complications such as infection, thrombosis, and bleeding. Unintentional arterial cannulation of a venous catheter is a rare but potentially dangerous complication. In the report, we describe the accidental cannulation of an artery with an epicutaneo-caval catheter in an extremely low birth weight infant. We discuss the physical and radiological findings that raise the suspicion of an arterial placement of a catheter, the diagnostic tools to confirm the misplacement, the potential complications, and strategies to prevent it.

Automated summary

Central venous access is essential in the care of critically ill neonates, but can lead to complications such as infection and thrombosis. Accidental arterial cannulation of a venous catheter is a rare but dangerous complication. Physical and radiological findings can raise suspicion, diagnostic tools are needed for confirmation, and strategies should be implemented to prevent potential complications.