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. 2024 Nov 30;24(98):1-6.
doi: 10.15557/jou.2024.0024. eCollection 2024 Dec.

Novel ultralow positioning of the umbilical artery catheter: A prospective pilot study

Anna Tomaszkiewicz  1   2 , Piotr Szymański  2   3 , Piotr Kruczek  2   3
Affiliations

Novel ultralow positioning of the umbilical artery catheter: A prospective pilot study

Anna Tomaszkiewicz et al. J Ultrason. .

Abstract

Objective: Thrombosis is a common complication of umbilical artery catheterization. The purpose of this study was to compare the novel ultralow umbilical artery catheter position (catheter tip at the junction of the umbilical and internal iliac arteries) versus the conventional high umbilical artery catheter position (tip in the aorta, above the diaphragm) for the incidence of thrombosis.

Study design: This study was conducted in a nonacademic, tertiary-referral neonatal center. The insertion and placement of the umbilical artery catheter was performed under continuous ultrasound guidance. Serial ultrasound examinations were performed to identify thrombosis in 38 consecutive newborns with an umbilical artery catheter placed in the novel ultralow position. The control group consisted of 50 infants with an umbilical artery catheter placed in the standard position.

Results: The incidence of thrombosis requiring anticoagulant treatment was 22% in neonates with an umbilical artery catheter in the standard position. No thrombosis was detected in those with an umbilical artery catheter placed in the ultralow position. The study and control groups had similar catheter indwelling times (mean, 8.2 ± 4.1 vs. 8.5 ± 4.0 days, p = 0.687).

Conclusions: This is the first report to present a novel position for the placement of umbilical artery catheters. The preliminary findings for the novel ultralow umbilical artery catheter position indicate that it may provide a safety benefit over the conventional umbilical artery catheter position.

Keywords: catheter position; neonate; thrombosis; ultrasound examination; umbilical artery catheter.

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Conflict of interest statement

Conflict of interest The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
UAC position: standard high position (left) and novel ultralow position (right). CT – celiac trunk; SMA – superior mesenteric artery; RA – renal artery
Fig. 2.
Fig. 2.
Ultralow position of the UAC with the catheter tip in the umbilical artery
Fig. 3.
Fig. 3.
Ultrasound image after removal of a UAC in the high position due to thrombosis. The thrombus extends to the superior pole of the kidney; the inferior pole of the kidney is outside the frame
See this image and copyright information in PMC

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References

    1. Ramasethu J Complications of vascular catheters in the neonatal intensive care unit Clin Perinatol. 2008;35:199. doi: 10.1016/j.clp.2007.11.007. : . ; : –. . Ramasethu J: Complications of vascular catheters in the neonatal intensive care unit. Clin Perinatol 2008; 35: 199–222. doi: . - DOI - PubMed
    1. Lin SJ, Koltz PF, Davis W, Vicari F Lower extremity ischemia following umbilical artery catheterization: a case study and clinical update Int J Surg. 2009;7:182. doi: 10.1016/j.ijsu.2008.12.038. : . ; : –. . doi: . - DOI - PubMed
    1. Alpert J, O’Donnell JA, Parsonnet V, Brief DK, Brener BJ, Goldenkranz RJ Clinically recognized limb ischemia in the neonate after umbilical artery catheterization Am J Surg. 1980;140:413. doi: 10.1016/0002-9610(80)90180-4. : . ; : –. . doi: . - DOI - PubMed
    1. Kempley ST, Gamsu HR Randomised trial of umbilical arterial catheter position: Doppler ultrasound findings Arch Dis Child. 1992;67:855. doi: 10.1136/adc.67.7_spec_no.855. : . ; : –. . doi: . - DOI - PMC - PubMed
    1. Schmidt B, Andrew M Neonatal thrombosis: report of a prospective canadian and international registry Pediatrics. 1995;96:939. : . ; : –. . - PubMed

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