Ultralow umbilical artery catheter placement: A large cohort analysis of safety in neonates

BACKGROUND: Umbilical arterial catheterisation is a routine procedure in neonatal intensive care units but is associated with thrombotic and other complications. This study evaluated the safety of an innovative ultralow umbilical artery catheter (UL-UAC) positioning technique in a cohort of 235 neonates. METHODS: This retrospective study assessed acute complications and thrombotic events following UAC placement with the UL-UAC technique, in which the catheter tip is positioned at the junction of the umbilical and internal iliac arteries under real-time ultrasound guidance. All catheter-related adverse events were recorded. RESULTS: No thrombotic complications were observed. Other adverse events, including minor bleeding after catheter removal, accidental dislodgment and central line-associated bloodstream infections (CLABSI), occurred in only 4.8% of cases. CONCLUSIONS: The ultrasound-guided UL-UAC method is safe and has the potential to reduce the risk of thrombosis while maintaining a low overall complication rate, therefore it can be considered an alternative to the standard and well-established technique.