Placement of Umbilical Artery Catheters High vs. Low |
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| Authors: | KATHLEEN B. SCANLON AB MSN LAWRENCE J. GRYLACK MD MOISES BORTEN MD |
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| Affiliation: | Kathleen B. Scanlon received her AB in psychology from Wilson College in Chambersburg, Pennsylvania;her basic nursing education in the Coordinated Program of Radcliffe College and the Massachusetts General Hospital;and her MSN from Boston University. She is a research associate at Georgetown University and clinical coordinator of the Neonatal Intensive Care Unit Developmental Evaluation Clinic at Columbia Hospital for Women, both in Washington, DC.;Lawrence J. Grylack received his MD degree from Tufts University Medical School in Boston, Massachusetts;was a resident in pediatrics at Bellevue Hospital in New York City and at Children's Hospital National Medical Center in Washington, DC;and was a Fellow in Neonatology at Georgetown University Hospital and Washington Hospital Center in Washington, DC. Dr. Grylack is Board-certified in Pediatrics and Neonatal–Perinatal Medicine, and is on the Board of Directors of the Society for Obstetric Anesthesia and Perinatology.;Moises Borten received his MD degree from the University of Buenos Aires in Argentina, did his pediatric residency in Argentina, and was a Fellow in Neonatology at Georgetown University Hospital in Washington, DC for two years. Dr. Borten practices neonatology in both Miami and Ft. Lauderdale, Florida. |
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| Abstract: | Placement of umbilical artery catheters was retrospectively reviewed in 181 newborns to evaluate random placement of catheter tip in the "high" position between T7 and T9 in the thoracic aorta of 127 infants and in the "low" position below 4 in the abdominal aorta of 54 infants. Group differences in gestational age, asphyxia, hypotension, respiratory disease, duration of catheterization, or infusate type were not significant. Cyanosis or blanching in the low extremities occurred in 67% of the "low" group and 21% of the "high" group ( P < .001). Hematuria occurred in 39% of the "low" group and 21% of the "high" group ( P < .05). High placement appears to have fewer complications. Prompt intervention by neonatal nurse practitioners can help reverse complications that occur during umbilical artery catheterizations. |
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