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August 1994

Picture of the Month

Author Affiliations
From the Division of Neonatology, Mary Black Memorial Hospital, Spartanburg, SC.
Arch Pediatr Adolesc Med. 1994;148(8):835-836. doi:10.1001/archpedi.1994.02170080065012

COMPLICATIONS RELATED to a standard nursery intervention developed in each of these infants (Figure 1 through Figure 4).

Denouement and Discussion 

Umbilical Artery Catheter–Related Thromboembolism 

DISCUSSION  Umbilical artery catheterization provides ready access in sick neonates to monitor the acid-base balance, to administer intravascular fluids and medications, and to obtain laboratory test samples. The utility provided by this route of access is tempered by a significant rate of complications. Among the reported problems associated with this form of intervention are arterial thrombosis, infections, catheter embolism, neurologic complications, hypertension, necrotizing enterocolitis, aortic aneurysms, and bleeding diatheses.1The most common complication of umbilical artery catheterization is thrombosis because the catheters may act as a foreign body nidus or they may cause damage to the vessel intima, which contributes to thrombus formation. The incidence of arterial thrombus formation has been reported to range from 3.5% to 60% of catheterized infants.2,3The wide