Neonatal arterial catheters: determinants and complications in a level III NICU experience

BACKGROUND: Arterial catheters (ACs) are essential in neonatal intensive care for hemodynamic monitoring and frequent blood sampling, but their use carries risks of complications. Data on neonatal and procedural predictors of clinically significant AC complications remain limited. The aim of this paper was to evaluate the frequency and nature of AC-related complications in neonates and identify associated clinical and procedural risk factors.METHODS: A retrospective observational study was conducted on 266 AC placements in 219 neonates admitted to a level III NICU from January 2020 to December 2024. Demographic, clinical, and catheter-related data were extracted from electronic health records. AC-related complications were defined as events requiring catheter removal. Statistical analyses assessed associations between complications and neonatal or catheter characteristics.RESULTS: AC-related complications occurred in 12.8% of cases, most commonly catheter dysfunction (6.8%). Radial and brachial sites had the highest complication rates, while umbilical catheters had the lowest (P