ADVANTAGES AND COMPLICATIONS OF UMBILICAL ARTERY CATHETERIZATION IN THE NEWBORN

PEDIATRICS ◽  
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.

Thrombotic Complications of Umbilical Artery Catheters: A Clinical and Radiographic Study

PEDIATRICS ◽  
1975 ◽  
Vol 56 (3) ◽  
pp. 374-379
Author(s):  
Boyd W. Goetzman ◽  
Robert C. Stadalnik ◽  
Hugo G. Bogren ◽  
Willard J. Blankenship ◽  
Richard M. Ikeda ◽  
...  
Keyword(s):  
Umbilical Artery ◽  
Newborn Infants ◽  
Direct Result ◽  
Thrombotic Complication ◽  
Reliable Technique ◽  
Arterial Blood ◽  
Sick Newborn ◽  
Thrombotic Complications ◽  
Umbilical Artery Catheterization ◽  
Blood Specimens

Catheterization of the aorta via the umbilical artery provides a convenient route for monitoring arterial blood pressure, for obtaining blood specimens for measurement of blood gas tensions and chemistries, and for the infusion of fluids and pharmacologic preparations in sick newborn infants. Use of this technique may be accompanied by a number of complications of which thrombotic phenomena are the most common. Twenty-three of 98 (24%) newborn infants undergoing umbilical artery catheterization were found to have thrombotic complications determined by aortography. No correlation was present between the duration of time that the umbilical artery catheters were in place and the occurrence of thrombotic complications. From paired aortographic or aortographic and autopsy studies in 24 patients, it was concluded that if a thrombotic complication did not occur early, none was likely to occur subsequently. One patient was considered to have died as a direct result of a thrombotic complication. Aortography is a safe, simple, and reliable technique for the early detection of thrombotic complications of umbilical artery catheters. Umbilical artery catheterization is not without risk and careful selection of patients for this procedure is indicated.

Validity of Neonatal Blood Pressure Obtained By The Manometric Method

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 293-296
Author(s):  
Rosemary D. Leake ◽  
Paul R. Williams ◽  
William Oh
Keyword(s):  
Blood Pressure ◽  
Neonatal Intensive Care ◽  
Umbilical Artery ◽  
Neonatal Intensive Care Units ◽  
Arterial Blood ◽  
Direct Recording ◽  
Blood Pressures ◽  
Manometric Method ◽  
Neonatal Blood ◽  
Precise Relationship

In neonatal intensive care units where direct arterial blood pressures obtained via a transducer are unavailable, a fluid-filled spinal manometer has been used. The latter method is practical and convenient although its validity has not been confirmed. This study is designed to establish the precise relationship between the blood pressure obtained by the manometric method and by direct recording via the arterial transducer. Materials and Methods Eleven infants with umbilical artery catheters in place 1 to 2 cm above the diaphragm were selected for the study. In all instances, the arterial catheters were placed for clinical management of various illnesses.

Check Umbilical Catheter Position

PEDIATRICS ◽  
1974 ◽  
Vol 54 (3) ◽  
pp. 384-384
Author(s):  
Philip D. Szold
Keyword(s):  
Case Report ◽  
Umbilical Artery ◽  
Catheter Position ◽  
X Ray ◽  
Umbilical Catheter ◽  
Umbilical Artery Catheterization

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.

An Unusual Complication of Umbilical Artery Catheterization

PEDIATRICS ◽  
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.

Abstract W P115: Utilization of Blood Sampling Global Oxygen Extraction Fraction and SPECT to Anticipate Cerebral Hyperperfusion Syndrome Following Elective Carotid Artery Stenting

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Takahisa Mori ◽  
Tomonori Iwata ◽  
Yuhei Tanno ◽  
Shigen Kasakura ◽  
Yoshinori Aoyagi ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Blood Sampling ◽  
Oxygen Extraction Fraction ◽  
Oxygen Extraction ◽  
Cerebral Hyperperfusion Syndrome ◽  
Hyperperfusion Syndrome ◽  
Cerebral Hyperperfusion ◽  
Arterial Blood ◽  
Extraction Fraction

Background: It is required to anticipate cerebral hyperperfusion syndrome (CHS) following carotid artery stenting (CAS). Purpose: The purpose of our retrospective study was to investigate whether or not blood sampling oxygen extraction fraction (OEF) and post-CAS CBF increase in SPECT had relation to CHS following CAS. Methods: Included in our analysis were patients (1) who underwent elective CAS in our institution between October 2010 and May 2014, and (2) who underwent blood sampling for OEF calculation before and immediately after CAS, and (3) who underwent SPECT before and just after CAS. OEF was calculated from cerebral arteriovenous oxygen difference. Arterial blood was sampled from the common carotid artery and venous blood from the dominant-sided superior jugular bulb. CHS was defined as pulsatile headaches, restlessness, convulsion, and/or new neurological symptoms not due to cerebral ischemia within seven days following CAS. CBF was measured before and just after CAS. CBF increase in the CAS side was defined as follows; (post-CAS CBF ratio - pre-CAS CBF ratio) of more than 10%, where CBF ratio was defined as CAS-sided fronto-parietal CBF divided by ipsilateral cerebellar CBF (%). Evaluated were baseline features in patients, pre-CAS OEF, post-CAS OEF, CBF ratio, CBF increase and CHS. Results: During the study period, 134 patients matched our criteria for analysis. Pre-CAS OEF was 0.41+-0.06, post-CAS OEF was 0.42+-0.08, pre-CAS CBF ratio: 88.7+-15.4%, CBF increase: 1.86+-12.3%. Nine patients presented CHS. Among them, pre-CAS OEF, CBF ratio and CBF increase were significant. ROC curves showed that pre-CAS OEF of 0.46 (p<0.001, OR: 9.3), CBF ratio of 92%(p<0.05, OR: 6.5), CBF increase of 8.8% (p<0.005, OR: 6.6) were cut-off values. Among 10 patients with pre-CAS OEF of more than 0.46 and CBF increase of more than 8.8%, 4 patients presented CHS (p<0.0001, OR;15.9). Conclusion: Elevation of pre-CAS OEF and increase of post-CAS CBF were strongly related to CHS.

scholarly journals Arterial blood sampling in male CD-1 and C57BL/6J mice with 1% isoflurane is similar to awake mice

2018 ◽  
Vol 125 (6) ◽  
pp. 1749-1759 ◽  
Author(s):  
Ashley M. Loeven ◽  
Candace N. Receno ◽  
Caitlin M. Cunningham ◽  
Lara R. DeRuisseau
Keyword(s):  
Cardiovascular Responses ◽  
Blood Chemistry ◽  
Blood Sampling ◽  
Optimal Time ◽  
Mouse Strains ◽  
Breathing Frequency ◽  
Breathing Patterns ◽  
Suitable Alternative ◽  
Arterial Blood Sampling ◽  
Arterial Blood

Isoflurane (ISO) is a commonly used anesthetic that offers rapid recovery for laboratory animal research. Initial studies indicated no difference in arterial Pco2 ([Formula: see text]) or pH between conscious (NO ISO) and 1% ISO-exposed CD-1 mice. Our laboratory investigated whether arterial blood sampling with 1% ISO is a suitable alternative to NO ISO sampling for monitoring ventilation in a commonly studied mouse strain. We hypothesized similar blood chemistry, breathing patterns, and cardiovascular responses with NO ISO and 1% ISO. C57BL/6J mice underwent unrestrained barometric plethysmography to quantify the pattern of breathing. Mice exposed to hypoxic and hypercapnic gas under 1% ISO displayed blunted responses; with air, there were no breathing differences. Blood pressure and heart rate were not different between NO ISO and 1% ISO-exposed mice breathing air. Oxygen saturation was not different between groups receiving 2% ISO, 1% ISO, or air. Breathing frequency stabilized at ~11 min of 1% ISO following 2% ISO exposure, suggesting that 11 min is the optimal time for a sample in C57BL/6J mice. Blood samples at 1% ISO and NO ISO revealed no differences in blood pH and [Formula: see text] in C57BL/6J mice. Overall, this method reveals similar arterial blood sampling values in awake and 1% ISO CD-1 and C57BL/6J mice exposed to air. Although this protocol may be appropriate in other mouse strains when a conscious sample is not feasible, caution is warranted first to identify breathing frequency responses at 1% ISO to tailor the protocol. NEW & NOTEWORTHY Conscious arterial blood sampling is influenced by extraneous factors and is a challenging method due to the small size of mice. Through a series of experiments, we show that arterial blood sampling with 1% isoflurane (ISO) is an alternative to awake sampling in C57BL/6J and CD-1 male mice breathing air. Monitoring breathing frequency during 1% ISO is important to the protocol and should be closely followed to confirm adequate recovery after the catheter implantation.

The Otoscope as a Transilluminator

PEDIATRICS ◽  
1980 ◽  
Vol 66 (2) ◽  
pp. 328-328
Author(s):  
Naoki Uga ◽  
Yoichi Kondo
Keyword(s):  
Blood Sampling ◽  
Arterial Blood Sampling ◽  
Posterior Tibial ◽  
Limited Space ◽  
Premature Babies ◽  
Arterial Blood ◽  
Tibial Arteries ◽  
Dark Room

We read with great interest the article by Dr Wall in the June 1977 issue reporting arterial blood sampling by transilluminator. However, sometimes it is very cumbersome to do arterial blood samplings or cannulation using the transilluminator in a limited space such as the neonatal incubator. We have found that the bright otoscope (Welch Allyn model no. 25000) without ear piece works out efficiently to locate radial, ulnar, dorsalis pedis, and posterior tibial arteries in premature babies in a dark room.

EFFECTS OF SINGLE UMBILICAL ARTERY LIGATION IN THE LAMB FETUS

PEDIATRICS ◽  
1968 ◽  
Vol 42 (6) ◽  
pp. 919-927
Author(s):  
George C. Emmanouilides ◽  
Duane E. Townsend ◽  
Robert A. Bauer
Keyword(s):  
Hydrogen Exchange ◽  
Umbilical Artery ◽  
Initial Period ◽  
Fetal Distress ◽  
Single Umbilical Artery ◽  
Artery Ligation ◽  
Term Survival ◽  
Indwelling Catheters ◽  
Fetal Survival ◽  
Arterial Blood

The effects of single umbilical artery ligation have been studied in 20 lamb fetuses, using chronic indwelling catheters placed in a retrograde fashion via the ligated umbilical artery in the fetal aorta. Fetal arterial blood pressure, heart rate, blood pH, PCO2 and PO2 were monitored at various intervals until the end of the gestation. The results indicate that prolonged fetal survival is possible. Although fetuses near term did not survive this insult, long-term survival (3 to 56 days) was observed in nine animals of earlier gestational age. After an initial period of hypoxia, acidosis, and hypercapnia, stabilization occurred and "normal" values for these parameters were observed. In spite of the apparently normal gas and hydrogen exchange between mother and fetus, profound fetal malnutrition was observed in two animals who survived 26 and 56 days, respectively. The possible mechanisms of fetal adaptation to this acute change in intra-uterine environment and the potential value of this "experimental model" for studying chronic fetal distress due to placental insufficiency are discussed.

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