Sir.—In the August 1987 issue of AJDC, Randel and colleagues,1 relating their experience with percutaneous peripheral arterial catheterization, mention common complications associated with umbilical catheterization; Goetzman2 states that, until additional information becomes available, some caution must be used in selecting the site for peripheral arterial access in the newborn.
This controversy gives us an opportunity to remind neonatologists of another option too often neglected3: in our opinion, whenever possible, a noninvasive technique should be preferred. For example, in nearly all cases where only blood gases are to be monitored, an arterial access is not mandatory.4 As for blood pressure monitoring, a slight reduction of accuracy with the noninvasive technique may be allowed without altering the quality of treatment because such a technique is without side effects.
Between January and December 1985, 210 infants admitted to the New York Columbia Presbyterian neonatal intensive care unit were
WILLARD D, MESSER J. Arterial Access and Monitoring in the Newborn. Am J Dis Child. 1988;142(5):480. doi:10.1001/archpedi.1988.02150050018006