166 Section V ■ Vascular Access
7. Catheter-related vascular compromise
8. Onset of platelet consumption coagulopathy
Fig. 29.14. Various UAC malpositions. A: Unacceptable position at L2 because of the proximity
of the renal arteries. B: UAC in left brachycephalic artery. C: UAC in right brachycephalic artery.
1. Leave umbilical tie loose around cord stump as precaution against excessive bleeding.
Reinsertion of purse-string suture through dried
Wharton jelly is preferable if
Chapter 29 ■ Umbilical Artery Catheterization 167
g. Misdirection of catheter into internal or external
iliac artery (see Figs. 29.14D and 29.17) (39).
Schreiber et al. (42) have described a doublearterial catheter technique to correct this problem.
a. Thrombosis (Fig. 29.18) (49–52)
b. Embolism/infarction (Fig. 29.17) (17,27) seen days
or weeks after line insertion (38)
c. Vasospasm (17,38,53,54) is seen within minutes to a
d. Loss of extremity (Fig. 29.19) (53)
e. Hypertension (Fig. 29.20) (18,55)
g. Congestive heart failure (aortic thrombosis) (57)
a. Breaks in catheter and transection of catheter (58)
b. Plasticizer in tissues (59,60)
(1) Improper grounding of electronic equipment
(2) Conduction of current through fluid-filled
d. Intravascular knot in catheter (61)
a. Hemorrhage (including that related to catheter loss
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