Supraventricular tachycardia associated with umbilical venous catheterization in neonates

Umbilical venous catheters (UVCs) are commonly used central venous access in the Neonatal Intensive Care Unit, especially in very low birth weight infants. Chest and abdominal radiograph, taken soon after catheter insertion, is the most common method for confirming catheter tip position. UVC-related complications commonly result from catheter malposition; hence, it is important to determine the catheter tip position accurately. However, complacency when a UVC is initially normal positioned can lead to late detection of subsequent UVC-related complications. We describe two cases of supraventricular tachycardia related to UVC, despite the initial UVC was in optimum position. The use of point-of-care echocardiography helped in the diagnosis of catheter malposition and minimized further medical intervention. We suggest point-of-care ultrasound assessment at regular intervals in all infants with UVC to ensure that the catheter is maintained in the optimum position.