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

J Vasc Access. 2022 Jul;23(4):624-627. doi: 10.1177/11297298211000871. Epub 2021 Mar 12.


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.

Keywords: Epicutaneo-caval catheter; arterial catheterization; central venous access; intensive care; neonatology; nursing; peripherally inserted central catheter; techniques and procedures; vascular access complications.

MeSH terms

  • Catheterization, Central Venous* / adverse effects
  • Catheters, Indwelling
  • Central Venous Catheters*
  • Critical Illness
  • Humans
  • Infant
  • Infant, Newborn
  • Thrombosis* / prevention & control