Name of the Procedure:

Catheterization, umbilical artery, newborn
Common name(s): Umbilical artery catheterization
Technical term(s): UAC placement

Summary

Umbilical artery catheterization is a medical procedure performed on newborns where a thin, flexible tube (catheter) is inserted into one of the umbilical arteries. This procedure is typically done to monitor blood pressure, draw blood samples, or administer medications and fluids directly into the bloodstream.

Purpose

Medical condition or problem: Respiratory distress, severe infection, metabolic imbalances, or other critical conditions requiring precise monitoring and management in newborns. Goals/Expected outcomes: Accurate blood pressure monitoring, frequent blood sampling without repeated needle sticks, and efficient administration of medications and fluids.

Indications

Symptoms or conditions: Premature birth, respiratory distress syndrome, sepsis, congenital heart disease, severe metabolic disorders. Patient criteria: Newborns, especially premature or critically ill babies who need intensive monitoring and management.

Preparation

Pre-procedure instructions: Generally, no specific preparation is required from the newborn. Diagnostic tests/assessments: Vital signs monitoring, blood tests, and sometimes a chest X-ray to confirm position after insertion.

Procedure Description

1. Position the newborn: The baby is placed in a supine position (lying on their back).
2. Sterilize the area: The umbilical area is cleaned with a sterile solution.
3. Identify the artery: The healthcare provider locates the umbilical artery.
4. Insert the catheter: A lubricated catheter is gently inserted into the umbilical artery.
5. Secure the catheter: Once in place, the catheter is secured to avoid displacement.
6. Confirm placement: An X-ray is often performed to confirm correct placement. Tools/Equipment: Sterile catheters, gloves, antiseptic solution, securing tapes, X-ray machine. Anesthesia/Sedation: Typically, no anesthesia is required due to the lack of pain receptors in the umbilical cord.

Duration

The procedure typically takes around 15-30 minutes.

Setting

Performed in a hospital, usually in a neonatal intensive care unit (NICU).

Personnel

Neonatologists, pediatricians, nurses specializing in neonatal care, radiologists.

Risks and Complications

Common risks: Infection at the insertion site, bleeding, blood vessel injury. Rare risks: Clots, catheter-related bloodstream infections, circulatory problems due to improper placement.
Management: Immediate medical intervention to address and manage any complications.

Benefits

Expected benefits: Precise monitoring of the critically ill newborn's condition, quick administration of life-saving treatments, reduced need for multiple needle sticks. Timing: Benefits can be realized immediately upon successful catheter placement.

Recovery

Post-procedure care: Ongoing monitoring of the catheter site for signs of infection or displacement. Recovery time: Continuous monitoring is required for as long as the catheter is in place; duration varies based on the baby's condition. Restrictions: Follow-up involves regular checks and possible X-rays to ensure catheter placement and function.

Alternatives

Other treatment options: Peripheral intravenous lines, central venous catheters, non-invasive monitoring systems. Pros/Cons: Peripheral lines are less invasive but offer less accuracy in monitoring and limited access for blood sampling; central venous catheters require similar insertion techniques with potentially higher risk of complications.

Patient Experience

During the procedure: The newborn is typically not conscious of pain due to the lack of nerve endings in the umbilical area. After the procedure: Close monitoring to ensure comfort, observation for potential signs of distress, and immediate intervention in case of complications. Pain management: Post-procedure comfort measures are taken, though the procedure itself is usually not painful.