Eoghan Edward Laffan BMBCH, Presenter: Nothing to Disclose

Ganesh Krishnamurthy MBBS, Abstract Co-Author: Nothing to Disclose

Lucia Fernanda Fontalvo MD, Abstract Co-Author: Nothing to Disclose

Hiliary Whyte MD, Abstract Co-Author: Nothing to Disclose

Patrick McNamara, Abstract Co-Author: Nothing to Disclose

Bairbre Louise Connolly MD, Abstract Co-Author: Nothing to Disclose

Peter Graham Chait MD, Abstract Co-Author: Nothing to Disclose

Philip John BA, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Very low birth-weight (VLBW) neonates require highly specialized intensive care. Interventional procedures, in this population, are challenging due to size, immaturity and severity of illness. Neonates are transported and monitored during the procedure by a dedicated neonatal team.

A respective review of all procedures on VLBW babies in the interventional radiology department in the last six years was performed. All procedural and/or patient-related complications were evaluated.

156 procedures were performed on 107 infants (66M, 41F). 34 (32%) patients had more than 1 procedure. Median gestational age at birth was 26/40 weeks (range 23 - 36). Median age and weight at time of procedure were 24 days (0 – 102) and 1000g (range 470 - 1500) respectively. Procedures included: PICC line insertions (73) or revisions (38) [exchanges/repositions /unblockage etc], jugular line insertions (27), G-tube (2) or NJ tube insertions (2), abdominal aspirations (4), nephrostomy (1), chest drain (1), liver abscess drainage (2), scalp abscess drainage (1). 5 procedures were terminated due to patient instability. Median fluoroscopic time was 3.8 minutes (0 – 22.5). Procedural complications included: contrast-related (2), catheter advancement problems (3), blood loss (2), cardiac tamponade (2). Patient complications included: hypothermia (3), bradycardia secondary to hypoxia (3) and tachyarrrhythmias (3). There were 2 post-procedural deaths (1 sepsis/hypothermia, 1 right atrial perforation).

Strict control of temperature, cardiorespiratory status and contrast administration are important issues for neonates undergoing interventional procedures. An interdisciplinary approach to patient care is imperative in minimizing neonatal morbidity outside of an ICU environment.

Laffan, E, Krishnamurthy, G, Fontalvo, L, Whyte, H, McNamara, P, Connolly, B, Chait, P, John, P, et al, , Six-year Review of Interventional Procedures in the Very Low-Birth-Weight Infant (Less Than 1.5kg): Complications, Lessons Learned, and Current Practice.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4419224.html