Umbilical arterial and venous catheters: placement, use, and complications

Umbilical catheters have been used in NICUs for drawing blood samples, measuring blood pressure, and administering fluid and medications for more than 25 years. Complications associated with umbilical catheters include thrombosis; embolism; vasospasm; vessel perforation; hemorrhage; infection; gastrointestinal, renal, and limb tissue damage; hepatic necrosis; hydrothorax; cardiac arrhythmias; pericardial effusion and tamponade; and erosion of the atrium and ventricle. A review of the literature provides conflicting accounts of the superiority of high versus low placement of umbilical arterial catheters. This article reviews the current literature regarding use of umbilical catheters in neonates. It also highlights the policy developed for the authors' NICU, a 34-bed tertiary care unit of a children's hospital, and analyzes complications associated with umbilical catheter use for 1 year in that unit.