Umbilical vein/artery catheterization (UVC, UAC)

Indication Umbilical vein catheter (UVC) During resuscitation, when peripheral venous access (PIV) is not possible If continuous administration of catecholamines (dopamine, epinephrine) is required Umbilical artery catheter (UAC) If invasive and continuous monitoring of arterial blood pressure is required To obtain blood for arterial blood gas measurements For gentle blood sampling in preterm neonates (minimal handling) ! A well-trained NETS-team should consider UVC placement in the delivery room: (1) as primary venous access and/or (2) as central venous access in an emergency or (3) in addition to peripheral IV access for further management on the NICU. Preparation Two 2-ml syringes Three-way stopcock (one per catheter) Normal saline solution for flushing the catheter, sterile needles for drawing normal saline solution Continuous infusion (CI) with normal saline plus heparin 1 U/ml intravenous solution Catheters: 2.5/3.5 (preterm infant) or 3.5/5 Ch (term infant) Single-lumen, double-lumen or triple-lumen catheter for umbilical vein Single-lumen end whole catheter for umbilical artery Scalpel, umbilical tape Suture and tape for fixation Two anatomical forceps, one surgical forceps, two to three pointed anatomical forceps Fine probe Sterile gauze pads Sterile drapes Sterile gown and sterile gloves, mask, cap (exeption: if child is in incubator, only sterile gloves are required) Make sure heat and light are adequate Place child in supine position (limb restraints may be required) Antiseptic solution (sterile gauze soaked in solution) Tip: Using alcoholskin disinfectants on the (very sensitive) skin of preterm/term infants can lead to toxic dermatitis and even skin necrosis. Liquid disinfectants that are antiseptic for mucous membranes and wounds are an alternative; however, they are not approved for skin disinfection. Allow 2 min for these antiseptic agents to take effect. […] © Cambridge University Press 2009.