Peripheral Arterial Lines in Extremely Preterm Neonates: A Potential Alternative to Umbilical Arterial Catheters
| Autor: | Lars Mense, Antje Bruck, Barbara Seipolt, Mario Rüdiger, Maxi Kaufmann, Stephanie Rose |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
business.industry
Extremely preterm Infant Newborn Gestational age Infant General Medicine humanities Umbilical Arteries Peripheral Discontinuation Umbilical arterial catheters Anesthesia Infant Extremely Premature Pediatrics Perinatology and Child Health Cohort Catheterization Peripheral Medicine Gestation Arterial line Humans Prospective Studies business Vascular Access Devices Retrospective Studies |
| Zdroj: | Advances in neonatal care : official journal of the National Association of Neonatal Nurses. 22(4) |
| ISSN: | 1536-0911 |
| Popis: | BACKGROUND Arterial catheterization is a routine procedure in extremely preterm neonates. Umbilical arterial catheters (UACs) are typically used for this purpose, but life-threatening complications have been described. Peripheral arterial lines (PALs) might offer a valuable alternative, but their feasibility in extremely preterm newborns is unclear. PURPOSE To investigate efficacy and complications of PALs in extremely preterm neonates. METHODS Retrospective analysis of patients born below 26 weeks of gestation in 2011-2014 (cohort 1, UAC as primary arterial access) and 2015-2019 (cohort 2, PAL as primary arterial access). Arterial line placement during their first 14 days of life, duration of arterial access, reasons for discontinuation, and long-term complications were recorded from health records. RESULTS In total, 161 of 202 newborns had an arterial line during their first 14 days of life. In cohort 2, the life span of a PAL was significantly longer than that in cohort 1. Signs of dysfunction were the primary reason to discontinue a PAL. Signs of peripheral ischemia were present in 36 of 105 cases (34%) when the PAL was removed but persisted in only 2 patients. UAC-associated persistent ischemic damage occurred in 2 of 97 patients. IMPLICATIONS FOR PRACTICE AND RESEARCH PALs are a valuable alternative to UACs even in preterm newborns below 26 weeks of gestational age. A special focus on ischemic complications is warranted. Prospective, multicenter studies to verify safety and efficacy of arterial line management and complications in extremely preterm infants are warranted. |
| Databáze: | OpenAIRE |
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