Umbilical artery catheterization by a cutdown procedure.

Abstract

In severely ill newborns conventional methods of umbilical artery catheterization sometimes fail to achieve a functioning intravascular line. In 18 of 19 such newborns requiring umbilical artery catheters for optimal management, successful catheterization was attained using a cutdown procedure on the umbilical arteries. Vascular perforation within the anulus umbilicalis, tunica intima invagination ahead of an advancing catheter, and subintimal cannulation were defined as the causes of initial catheterization failure in all 19 newborns.