Serious Complications After Umbilical Artery Catheterization for Neonatal Monitoring

On reading the brief recording, "Gangrene of the Buttock: A Complication of Umbilical Artery Catheterization,"1 I was convinced that because the contribution was included in Experience and Reason, the conclusion would be to always obtain an adequate x-ray after catheterization to verify proper positioning. Such an x-ray was not obtained until more than 30 hours postcatheterization in the above-mentioned case report. However, I reached the end of the article with no mention of the importance of these x-ray studies.

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An Unusual Complication of Umbilical Artery Catheterization

PEDIATRICS ◽

10.1542/peds.49.2.281 ◽

1972 ◽

Vol 49 (2) ◽

pp. 281-283

Author(s):

Donald A. Lackey ◽

Paddy Taber

Keyword(s):

Umbilical Artery ◽

Clinical Course ◽

Unusual Complication ◽

Umbilical Vessel ◽

Umbilical Artery Catheterization

Attention is called to the clinical course of a neonate who experienced the accidental retro-grade loss of part of a polyvinyl catheter into the aorta. This had occurred after treatment via an umbilical artery had been completed, and attempts to remove the catheter had resulted in its breaking. The management of this problem is presented, and the various complications of umbilical vessel cathethenization are reviewed.

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Neonatal Bladder Injury Occurring After Umbilical Artery Catheterization by Cutdown

JAMA ◽

10.1001/jama.1983.03340210066029 ◽

1983 ◽

Vol 250 (21) ◽

pp. 2968 ◽

Cited By ~ 3

Author(s):

Joel M. Kaufman

Keyword(s):

Umbilical Artery ◽

Bladder Injury ◽

Umbilical Artery Catheterization

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ADVANTAGES AND COMPLICATIONS OF UMBILICAL ARTERY CATHETERIZATION IN THE NEWBORN

PEDIATRICS ◽

10.1542/peds.42.5.769 ◽

1968 ◽

Vol 42 (5) ◽

pp. 769-777

Author(s):

William D. Cochran ◽

Heather T. Davis ◽

Clement A. Smith

Keyword(s):

Fluid Therapy ◽

Causes Of Death ◽

Umbilical Artery ◽

Fluid Administration ◽

Blood Sampling ◽

Indwelling Catheter ◽

Local Complications ◽

Arterial Blood ◽

Umbilical Artery Catheterization

During a period of 5 years, 8 months, umbilical artery catheterization was performed on 387 infants in a newborn nursery. The indwelling catheter, at first introduced only to secure arterial blood for diagnostic and investigative purposes, was subsequently employed for intravascular fluid therapy in the same infant, and ultimately (in 51 of the 387 infants) for such fluid therapy alone. Complications observed were either vasospasm and temporary blanching of an extremity (13 infants: 11 surviving without apparent sequelae, 2 dying but without local complications at autopsy) or thrombosis, arteritis, or other inflammation noted at postmortem (18 infants). Such complications were not causes of death at autopsy, but their finding suggests the need for limiting the procedure to infants in whom any other route of blood sampling or fluid administration is particularly difficult.

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