[Percutaneous cannulation of the radial artery in severely ill premature and newborn infants]

Abstract

Cannulation of the radial artery is an easy and safe alternative to the usual procedure of catheterization of the umbilical artery to secure blood for gas sampling and for monitoring blood pressure in critically ill neonates. The use of a fiberoptic light source further improves the success of percutaneous radial artery cannulation. We performed this procedure in 264 critically ill babies and it was successful in 211 (80%). The average weight was 2.160 g (740-4,300), gestational age was 33 weeks (26-45). The radial artery catheter had an average useful life of 5 days (1-22). In 53 newborn infants the catheter had to be removed prematurely because obtaining blood samples was no longer possible. In 15 babies the catheter had to be removed on account of arterial spasms. One patient developed skin necrosis of a small area on the tip of the thumb due to a thrombo-embolic complication. No case of bacterial infection due to cannulation was observed. No neurological disturbance in hand or finger function was found on follow up after one year. In conclusion, this method is safe, easy to handle, has less complications and several advantages over previous methods.