Should we put catheters in the umbilical artery?

Abstract

A catheter inserted in the umbilical artery with its tip in the aorta provides a convenient means for obtaining arterial blood samples, measuring pressure, and infusing fluids and drugs. Although these catheters often seem necessary to guide the treatment of newborn infants who have cardiopulmonary disease, they are dangerous. They are associated with thrombi, emboli, and infection. Their presence provokes vascular constriction and invites the infusion of vasoactive substances. Some catheter complications can be catastrophic. Recent reports include cases of hypertension,¹ paraplegia,² and septic osteoarthritis.³ In the past two years we have seen gangrene of a foot, a leg, and the lower half of the body.