Umbilical Artery Catheterization
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The first cannulation of an umbilical artery is attributed to Dr Virginia Apgar in the late 1950s. Today, umbilical artery catheterization is a common procedure in the neonatal intensive care unit and has become the standard of care for arterial access in neonates. The umbilical artery can be used for arterial access during the first 5-7 days of life, but it is rarely used beyond 7-10 days. Placement of an umbilical artery catheter is easy in principle but often challenging in practice.
Umbilical artery catheterization affords direct access to the arterial blood supply and allows accurate measurement of arterial blood pressure, serves as a source of arterial blood sampling, and provides intravascular access for fluids and medications. [1]
Indications for umbilical artery catheterization include the following:
Contraindications for umbilical artery catheterization include the following:
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Rosenfeld W, Estrada R, Jhaveri R, Salazar D, Evans H. Evaluation of graphs for insertion of umbilical artery catheters below the diaphragm. J Pediatr. 1981 Apr. 98(4):627-8. [Medline].
Shukla H, Ferrara A. Rapid estimation of insertional length of umbilical catheters in newborns. Am J Dis Child. 1986 Aug. 140(8):786-8. [Medline].
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MacDonald MG, Ramasethu J. Umbilical artery catheterization. Atlas of Procedures in Neonatology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2002. 152-70.
Vernooij CM, Hogeman PH, Nikkels PG, Blok CA, Brouwers HA. Necrosis of the left buttock as a complication of umbilical catheterisation in neonatal resuscitation. Arch Dis Child Fetal Neonatal Ed. 2007 Jan. 92(1):F48. [Medline].
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Taylor L Sawyer, DO, MEd, FAAP, FACOP Associate Professor of Pediatrics, University of Washington School of Medicine; Director, Neonatal-Perinatal Fellowship, Seattle Children’s Hospital
Taylor L Sawyer, DO, MEd, FAAP, FACOP is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American College of Osteopathic Pediatricians, American Medical Association, American Osteopathic Association, Association of American Medical Colleges, International Pediatric Simulation Society, Society for Simulation in Healthcare
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Vincent Lopez Rowe, MD Professor of Surgery, Program Director, Vascular Surgery Residency, Department of Surgery, Division of Vascular Surgery, Keck School of Medicine of the University of Southern California
Vincent Lopez Rowe, MD is a member of the following medical societies: American College of Surgeons, American Surgical Association, Pacific Coast Surgical Association, Society for Clinical Vascular Surgery, Society for Vascular Surgery, Western Vascular Society
Disclosure: Nothing to disclose.
James Michael Luchetti, MD Clinical Assistant Professor, Department of Pediatrics, United States University of Health Services F E Hebert Medical School; Clinical Instructor, Department of Pediatrics, University of Hawaii John A Burns School of Medicine; Chief of Newborn Services, Staff Neonatologist, Tripler Army Medical Center
Disclosure: Nothing to disclose.
Acknowledgments
The views expressed are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.
The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the assistance of Lars J Grimm, MD, MHS, with the literature review and referencing for this article.
Umbilical Artery Catheterization
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