Abstract
Background and aims: Insertion of umbilical arterial catheters (UAC) is a routine urgent procedure in sick preterm to facilitate continuous blood pressure monitoring and frequent arterial blood sampling. Once the umbilical arteries have constricted, catheter insertion can be difficult or unsuccessful. Aims: To compare the success rates of UAC insertion in preterm infants born ≤ 27 0/7 weeks of gestation in the delivery room or after admission to the NICU. Methods: Comparative cohort study of all preterm infants born alive at ≤ 27 0/7 weeks of gestation who required an UAC placement and were admitted to our NICU. In infants who were born between January 1, 2008 and September 30, 2010, UAC insertion was attempted after admission to the NICU (cohort I). Starting on October 1, 2010 unit policy was changed and UAC insertion was attempted in the DR (cohort II). Results: A total of 81 infants were included in the analyses (cohort I: 44 infants, cohort II: 37 infants). The two groups were comparable with respect to gestational ages, birth weights, prenatal history, delivery mode and postnatal adaptation. Early attempts of UAC insertion in the DR were associated with higher success rates compared with late attempts in the NICU (97% vs. 77%, respectively, p=0.007 Fisher’s exact test). There were no statistically significant differences in complication or mortality rates. Conclusions: UAC Insertion in the DR within the first 30 minutes of life is feasible and is associated with a higher success rate when compared with delayed insertion in the NICU.
Published Version
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