Radial arterial catheters in children and neonates

Selldén, Hans; Nilsson, Kristina; Larsson, L. E.; Ekström-Jodal, B

doi:10.1097/00003246-198712000-00006

Cited by 56 publications

(34 citation statements)

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“…57 Acute impairment of arterial blood flow to the hand or foot is characterized by diminished or absent pulses, a prolonged capillary refill time, and a cool, pale hand or foot. Doppler ultrasound is usually used to provide confirmation of the TE.…”

Section: Peripheral Arterial Cathetersmentioning

confidence: 99%

“…54 Peripheral lines: Three studies show that UFH prolongs the patency of peripheral lines. [57][58][59] Sellden et al assessed intermittent vs continuous flushing with UFH containing solutions in 338 infants less than 1 year of age with radial arterial catheters. 57 Catheters were removed due to malfunction in 76% of patients receiving intermittent flushes compared to 52% of patients receiving continuous infusions of UFH.…”

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

“…[57][58][59] Sellden et al assessed intermittent vs continuous flushing with UFH containing solutions in 338 infants less than 1 year of age with radial arterial catheters. 57 Catheters were removed due to malfunction in 76% of patients receiving intermittent flushes compared to 52% of patients receiving continuous infusions of UFH. 57 In a randomized controlled trial, Rais-Bahrami et al evaluated premature catheter removal in 60 newborns with peripheral arterial catheters.…”

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

“…57 Catheters were removed due to malfunction in 76% of patients receiving intermittent flushes compared to 52% of patients receiving continuous infusions of UFH. 57 In a randomized controlled trial, Rais-Bahrami et al evaluated premature catheter removal in 60 newborns with peripheral arterial catheters. 58 Patency of peripheral arterial catheters was prolonged in infants receiving UFH normal saline flushes compared to UFH dextrose flushes.…”

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

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Thromboembolic Disease and Antithrombotic Therapy in Newborns

Andrew¹,

Monagle²,

deVeber³

et al. 2001

Hematology

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This update uses an evidence based approach to analyze and present the epidemiology of neonatal thrombosis, etiologies, currently used techniques for diagnosis with their limitations, and current therapeutic approaches. In addition, the approaches to both prevention and optimal therapies are discussed.In Section I Dr. Paul Monagle addresses the epidemiology of neonatal thrombosis outside of the central nervous system in both arterial and venous locations, and those that occur in utero. The specific contributions of catheters and congenital prothrombotic disorders are delineated. Dr. Monagle also describes currently used techniques for the diagnosis of thrombotic events as well as their limitations and the current therapeutic approaches.In Section II, Dr. Gabrielle deVeber reviews the epidemiology of neonatal thrombosis within the central nervous system, in both arterial and venous locations and those that occur in utero. The neurological presentation, risk factors including congenital prothrombotic disorders, anatomical distribution, diagnostic tests, use of antithrombotic therapy and neurologic outcome of neonates with either sinovenous thrombosis or arterial ischemic stroke are discussed.In Section III, Dr. Anthony Chan reviews the current approaches to the prevention and treatment of neonatal thrombosis. Information on the differences in the response of neonates compared to adults to antithrombotic therapy and new approaches to the prevention and treatment of thrombosis in neonates are emphasized.Thromboembolic events (TEs) during childhood are increasing in their frequency and severity, and occur in children surviving previously life-threatening primary diseases. Newborns comprise the largest group of children developing TEs. This paper discusses the epidemiology, diagnostic tests, acquired and congenital prothrombotic risk factors, long-term outcomes, and antithrombotic therapy for the management of TEs in newborns. Due to the unique features and the significance of TEs in the central nervous system (CNS), sinovenous thrombosis (SVT) and arterial ischemic stroke (AIS) will be considered separately; cerebrovascular lesions in premature infants will not be discussed.In preparation for this manuscript, comprehensive Medline reviews were performed to identify all relevant publications, which were analyzed based upon the study design; results of studies with stronger designs were given more influence in the analysis. The striking features of this review were the deficiencies in our knowledge with respect to appropriate diagnostic strategies, optimal therapy for newborns with TEs, and the contribution of congenital prothrombotic disorders. Well-designed trials are required to improve our ability to care for neonates with TEs.

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Section: Peripheral Arterial Cathetersmentioning

confidence: 99%

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

Section: Guidelines For Antithrombotic Agentsmentioning

confidence: 99%

See 2 more Smart Citations

Thromboembolic Disease and Antithrombotic Therapy in Newborns

Andrew¹,

Monagle²,

deVeber³

et al. 2001

Hematology

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“…Arterial catheterization is a common practice in NICU, which is part of the routine management of high -risk neonates, and reduces distress by reducing the need for vein puncture and heel cut capillary emia may be detected immediately 11,12) . In contrast to umbilical arterial catheterization, there were many potential complications such as arterial thromboses, NEC associated with this management, and aortic wall vascular complications in animal models of extreme prematurity have been reported 13,14) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Arterial Catheter Management in Very Preterm Neonates: Peripheral Artery Versus Umbilical Artery

Imamura¹,

Momoi²,

Go³

et al. 2012

Fukushima J. Med. Sci.

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:Objectives : To evaluate whether peripheral arterial catheter management is more effective than umbilical arterial management in very preterm neonates.Methods : Thirty -eight very preterm neonates born in Fukushima Medical University Hospital between October 2008 and March 2010 were evaluated. A peripheral arterial catheter was inserted in 19 neonates (peripheral group) and an umbilical arterial catheter in the remaining 19 neonates (umbilical group).Results : The median gestational ages of the peripheral and umbilical groups were 195 and 185 days, respectively (p=0.04). The systolic and diastolic blood pressure (BP) was significantly higher in the peripheral group than in the umbilical group (p=0.03 and p=0.001). There was a significant relationship between BP at cannulation and urinary output after cannulation for 24 h in the peripheral group (r s =0.49, p=0.03) ; however, no such significant relationship was found in the umbilical group.Conclusions : We considered that peripheral artery catheters provide a well -functioning route for continuous BP monitoring, even in very preterm neonates. Because umbilical catheter placement might affect urinary output, we speculated that peripheral arterial catheter placement would be a more effective management strategy than umbilical arterial catheter placement in very preterm neonates. Further studies of larger populations are necessary to evaluate the effectiveness of arterial management including long -term follow -up studies.

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