Novel ultralow positioning of the umbilical artery catheter: A prospective pilot study.

Objective: Thrombosis is a common complication of umbilical artery catheterization. The purpose of this study was to compare the novel ultralow umbilical artery catheter position (catheter tip at the junction of the umbilical and internal iliac arteries) versus the conventional high umbilical artery catheter position (tip in the aorta, above the diaphragm) for the incidence of thrombosis.

Study design: This study was conducted in a nonacademic, tertiary-referral neonatal center. The insertion and placement of the umbilical artery catheter was performed under continuous ultrasound guidance. Serial ultrasound examinations were performed to identify thrombosis in 38 consecutive newborns with an umbilical artery catheter placed in the novel ultralow position. The control group consisted of 50 infants with an umbilical artery catheter placed in the standard position.

Results: The incidence of thrombosis requiring anticoagulant treatment was 22% in neonates with an umbilical artery catheter in the standard position. No thrombosis was detected in those with an umbilical artery catheter placed in the ultralow position. The study and control groups had similar catheter indwelling times (mean, 8.2 ± 4.1 vs. 8.5 ± 4.0 days, p = 0.687).

Conclusions: This is the first report to present a novel position for the placement of umbilical artery catheters. The preliminary findings for the novel ultralow umbilical artery catheter position indicate that it may provide a safety benefit over the conventional umbilical artery catheter position.