FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 299:561-564 September 14, 1978 Number 11 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We performed a randomized prospective study of the effect of placement position of umbilical-artery catheters on complication rates in high-risk newborn infants. A higher complication rate (31 of 40 vs. 13 of 33) (P less than 0.005) occurred in the group with the catheter tip at the third to fourth lumbar segment, as compared to those with the tip at the seventh to eighth thoracic segment, owing to more episodes of blanching and cyanosis of the extremities. There was no difference between groups in the rate of complications requiring catheter removal. Aortography revealed thrombosis in 21 of 23 patients studied, but there was no clinical evidence of impaired circulation. In retrospect, we found that, independently of catheter position, administration of antibiotics through the catheter was associated with an increased rate of complications (63 vs. 20 per cent). Umbilical-artery catheterization entails potential risks regardless of the position of the catheter; placement of the catheter with its tip at the seventh to eighth thoracic segment may be associated with fewer complications than at lower positions.

This article has been cited by other articles:

• Monagle, P., Chalmers, E., Chan, A., deVeber, G., Kirkham, F., Massicotte, P., Michelson, A. D. (2008). Antithrombotic Therapy in Neonates and Children: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 887S-968S [Abstract] [Full Text]  
• Monagle, P., Chan, A., Massicotte, P., Chalmers, E., Michelson, A. D. (2004). Antithrombotic Therapy in Children*: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 645S-687S [Abstract] [Full Text]  
• Tiffany, K. F., Burke, B. L., Collins-Odoms, C., Oelberg, D. G. (2003). Current Practice Regarding the Enteral Feeding of High-Risk Newborns With Umbilical Catheters In Situ. Pediatrics 112: 20-23 [Abstract] [Full Text]  
• Schulz, G., Keller, E., Haensse, D., Arlettaz, R., Bucher, H. U., Fauchere, J.-C. (2003). Slow Blood Sampling From an Umbilical Artery Catheter Prevents a Decrease in Cerebral Oxygenation in the Preterm Newborn. Pediatrics 111: e73-76 [Abstract] [Full Text]  
• Mathers, L. H. JR (1990). Anatomical Considerations in Obtaining Arterial Access. J Intensive Care Med 5: 110-119 [Abstract]  
• Rodriguez, M., Sosenko, I. (1989). Catheter-induced Aortic Thrombus Masquerading as Coarctation of the Aorta. CLIN PEDIATR 28: 581-584 [Abstract]  
• Rubin, B. K., McRobert, E., O'Neill, M. B. (1986). An Alternate Technique to Determine Umbilical Arterial Catheter Length. CLIN PEDIATR 25: 407-408 [Abstract]