Percutaneous femoral arterial and venous catheterisation during neonatal intensive care
S P Wardlea, A W R Kelsallb, C W Yoxallc, N V Subhedarc
a Department
of Child Health, University of Liverpool, Liverpool Women's Hospital,
Liverpool, UK, b Neonatal
Intensive Care Unit, Rosie Hospital, Addenbrooke's Hospital,
Cambridge, UK, c Neonatal
Intensive Care Unit, Liverpool Women's Hospital
Correspondence to: Dr Subhedar, Neonatal Intensive Care Unit, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK nvsubhedar_lwh{at}yahoo.com
Accepted 8 June 2001
BACKGROUND
Femoral
vessel catheterisation is generally avoided in the neonatal period
because of technical difficulties and the fear of complications.
AIMTo review the use
of femoral arterial and venous catheters inserted percutaneously on the
neonatal intensive care unit.
METHODSInfants
admitted to one of two regional neonatal intensive care units who
underwent femoral vessel catheterisation were identified. Information
collected included basic details, indication for insertion of catheter,
type of catheter and insertion technique, duration of use, and any
catheter related complications.
RESULTSSixty five
femoral catheters were inserted into 53 infants. The median gestational
age was 29 weeks (range 23-40). Twenty three femoral arterial
catheters (FACs) were inserted into 21 infants and remained in situ for
a median of three days (range one to eight). Twelve (52%) FACs
remained in place until no longer required, and four (17%) infants
developed transient ischaemia of the distal limb. Forty two femoral
venous catheters (FVCs) were inserted into 40 infants and remained in
situ for a median of seven days (range 1-29). Twenty seven (64%) FVCs
remained in place until no longer required, and eight (19%) catheters
were removed because of catheter related bloodstream infection.
CONCLUSIONSFACs and
FVCs are useful routes of vascular access in neonates when other sites
are unavailable. Complications from femoral vessel catheterisation
include transient lower limb ischaemia with FACs and catheter related
bloodstream infection.
Keywords: femoral venous catheter; femoral arterial catheter; central venous access
© 2001 by Archives of Disease in Childhood
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