Topics Discussed: abdominal paracentesis; paracentesis.
Excerpt:"Indications
- To obtain peritoneal fluid for diagnostic tests to determine the cause of ascites. Ascites can be caused by or associated with necrotizing enterocolitis with perforation; biliary, urinary, chylous, or meconium peritonitis; iatrogenic or congenital infections; or inborn errors of metabolism.
- As a therapeutic procedure, such as removal of peritoneal fluid or air from a pneumoperitoneum to aid in ventilation in a patient with cardiorespiratory compromise.
Equipment. Sterile drapes, sterile gloves, povidone-iodine solution, sterile gauze pads, sterile tubes for fluid, a 10-mL syringe, and a 22- or 24-gauge catheter-over-needle assembly (24 gauge for infants weighing <2000 g, 22–24 gauge for infants weighing >2000 g).
Procedure
- The infant should be supine with both legs restrained. To restrict all movements of the legs, a diaper can be wrapped around the legs and secured in place.
- Choose the site for paracentesis. The area between the umbilicus and the pubic bone is not generally used in neonates because of the danger of perforating the bladder or bowel wall. The sites most frequently used are the right and left..."
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