Umbilical artery catheters - routines?

[Stefan Johansson]

Dear all,

in our units most extremely preterm infants get umbil artery catheters (UACs), high position, and we tend to keep those for quite many days. In the most immature infants (23-24 weeks), sometimes up to 10-12 days, but usually we take it away at the end of the first week of life.

We place peripheral radial artery catheters if those infants deterioate later (sepsis etc).

Although we hardly see complications such as distal gangrene och symptomatic aortic thrombosis, I have a feeling that this practise of keeping UACs for many days is different from the routines in other units.

What is your routines/protocols for UACs?

[manberbenitez]

dear stefan

we leave the arterial catheters only 5 days, there are reports of hyperreninemic hypertension ( usually low catheters).We use it high.

your friend

manuel

[Guest Joskumaria]

In our unit, we don`t use umbilical catheters at all. I presume that our doctors think it`s a little bit "old fashion -way". And I don´t quite frankly understand why.

Babys get a peripheral radial artery catheter and other peripheral lines for TPN and medicins. A neonate will get a UAC if the doctor won`t get any other line. And if that`s the case, they want to take the UAC away as soon as possible and replace it with peripheral line.

From my point of view as a NICU nurse, UACs are better and safer when nursing a baby. Plus you don`t have to cause pain to small baby when placing them. So my thougts are very much based on the NIDCAP.

RN Johanna from Finland

[T.Roberts RNC]

I am also a NICU nurse. We leave our UACs in place as long as we need them and they continue to function properly. We prefer high placement. We will use PAL if UAC becomes unusable or if baby develops need for the line after the umbilicus is dry. We have many fewer complications/line malfunctions/displacements with UACs.

[Hans Joergen]

In our NICU the preterm infants (including 24+ weeks) needing artery catheters normaly get a peripheral radial artery catheter. Very seldom is a UAC used, only if there is dificulties with peripheral lines. To my knowledge there have not been any complications. We keep it as long as needed, normaly 5-6 days.

Dr Hans Joergen Guthe

Childrens Department

Haukeland University Hospital

Bergen, Norway

[sudershan.kumari]

The umbilical arterial catheter is used only for about 5-6 days by that time most term babies are off ventilation. Also i have a feeling that infection rate increases if along with sepsis we keep catheters for longer than 7 days. Peripheral arteial line is also used frequently in vlbw babies.Complications are very rare, the catheter is removed at first suspicion . However umbilical venous catheter may be placed for a longer time if getting veins is a problem .as we start trophic feeds from day 2 ,need for pareneral nutriioin is much less with us

[Guest]

In our NICU the preterm infants (including 24+ weeks) needing artery catheters normaly get a peripheral radial artery catheter. Very seldom is a UAC used, only if there is dificulties with peripheral lines. To my knowledge there have not been any complications. We keep it as long as needed, normaly 5-6 days.

Dr Hans Joergen Guthe

Childrens Department

Haukeland University Hospital

Bergen, Norway

why isn't the UAC/ UVC your first choice of access? from what I have experienced, it is more stable than a PAL for sampling, and the uvc far more secure than repeated peripheral lines, especially for use with TPN. I know they may not last awhile, but i do feel more secure with this mode of access. just my two pennys worth!

arlene.

[Guest Rahmi]

I do not prefer to keep umbilical cathaters ( high level) after 6 or 7 days. But rarely it lasted 12 days. What is your experience regarding maximum duration?

[pooperscooperrn0624]

Ideally we like to remove umbilical cathers within a week. However, with an unstable VLBW infant we have left them in several weeks while culturing for infection.

[Guest bittybabygrower]

We use the UAC for up to 10 days and the double lumen UVC for as long as we need or until we can get central access per PICC line or CVL. In extreme cases we will put our TPN thru the UAC if there is no central line.