Colonic Perforation Secondary to Thrombo‐embolus From an Umbilical Artery Catheter

Anderson, Alfred J.; Höfer, Pauline; Holmlund, D; Wendel, H

doi:10.1111/j.1651-2227.1974.tb04366.x

Cited by 11 publications

(1 citation statement)

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“…The placement of UACs can be challenging, and infrequent but potentially serious complications can occur such as thrombo‐embolism, vasospasm and vessel perforation . Injury to gastrointestinal tissue, spinal cord and nerves, gluteal and perineal region, renal, and limbs has also been reported. Peripheral arterial line placement in infants weighing <1000 g at birth can be technically difficult.…”

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confidence: 99%

Are there changes to regional tissue oxygenation and circulation following umbilical artery catheter placement? A prospective cohort study in newborn infants

Jani

Hinder

Badawi

et al. 2019

J Paediatrics Child Health

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Aim: The use of umbilical arterial catheters (UACs) is a standard of care in monitoring critically unwell infants. Serious vascular complications are rare but when they do occur, they can be associated with significant morbidity, risking limb loss or even death. Near infra-red spectroscopy has the potential to monitor limb perfusion. Our study investigates changes in tissue oxygenation and perfusion in the abdominal and leg circulation following UAC insertion. Methods: A prospective observational study performing ultrasound pulsed Doppler measurements in the coeliac, superior mesenteric artery, renal arteries and the femoral arteries as well as near infrared spectroscopy measurements of both thighs at three time points (immediately before = Time 1, 1 h after = Time 2 and 24 h after UAC insertion = Time 3). Results: We monitored 30 infants, the mean gestational age was 30 weeks (24-41) and the mean birthweight was 1720 g (600-4070 g). We observed statistically significant changes (P < 0.05) in pulse Doppler measurements in coeliac (mean peak systolic velocity (PSV): Time 1 = 70.51, Time 2 = 61.75; resistive index (RI): Time 1 = 0.75, Time 2 = 0.67), superior mesenteric (PSV: Time 1 = 41.72, Time 2 = 36.10; RI: Time 1 = 0.92, Time 2 = 0.87), renal (same side end-diastolic velocity: Time 1 = 1.98, Time 2 = 3.80; RI: Time 1 = 0.93, Time 2 = 0.87; opposite side end-diastolic velocity: Time 1 = 2.62, Time 2 = 3.84; RI: Time 1 = 0.92, Time 2 = 0.85) and femoral arteries (same side PSV: Time 1 = 72.75, Time 2 = 62.18; opposite side PSV: Time 1 = 81.89, Time 2 = 62.74). Tissue oxygenation in lower limbs remained unaffected (same side (mean): Time 1 = 68.59, Time 2 = 68.99, Time 3 = 66.40, opposite side: Time 1 = 67.72, Time 2 = 66.92, Time 3 = 65.40). All infants on clinical examination had normal lower limb perfusion, lower limb arterial pulses and normal perfusion to the gluteal region before and after insertion of UAC.Conclusions: While sub-clinical changes in perfusion occur in abdominal and leg circulation, these changes are not consistent across vessels and regional tissue oxygenation remains unaffected.

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confidence: 99%