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Jeffrey L. Marsh, MD; William King, MD; Cynthia Barrett, MD; Eric W. Fonkalsrud, MD

Arch Surg. 1975;110(10):1203-1208.

Abstract
Umbilical artery catherization in critically ill neonates caused major complications, including five deaths, in 15 of 165 infants with respiratory distress syndrome who underwent autopsy at the UCLA Hospital during the past eight years. Arterial occlusion leading to visceral infarction occurred in 12 patients, and vascular perforation caused hemoperitoneum in three patients. Repeated catheter manipulation and protracted catheter use were common factors identified in patients in whom complications developed. Restricted indications for catheter use, routine roentgenographic confirmation of catheter tip location below the kidneys, low-dosage heparin sodium infusion, use of cannulas with decreased thrombogenicity, avoidance of catheter manipulation, and vigilance to remove catheters when no longer required should reduce the incidence of this iatrogenic neonatal complication while still permitting arterial pressure and blood gas monitoring when clinically indicated.

Author Affiliations
From the departments of surgery (Drs. Marsh, King, and Fonkalsrud) and pediatrics (Dr. Barrett), UCLA School of Medicine, Los Angeles.

Footnotes
Accepted for publication Feb 11, 1975.

Read before the annual meeting of the Southern California Chapter of American College of Surgeons, Santa Barbara, Calif, Jan 19, 1975.

Reprint requests to Department of Surgery, Center for Health Science, UCLA School of Medicine, Los Angeles, CA 90024 (Dr. Fonkalsrud).

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