Fig. 29.15. Anteroposterior (A) and lateral (B) radiographs demonstrating passage of a UAC into the

pulmonary artery via a patent ductus arteriosus.

a. Umbilical tape must be tied on skin rather than

Wharton jelly.

b. Catheter has been in situ for longer than 48 hours,

because artery may have lost ability to spasm.

2. Withdraw catheter slowly and evenly, until approximately 5 cm remains in vessel, tightening purse-string

suture or umbilical tie.

3. Discontinue infusion.

4. Pull remainder of catheter out of the vessel at rate of

1 cm/min (to allow vasospasm). If there is bleeding,

apply lateral pressure to the cord by compressing

between thumb and first finger.

J. Complications (38–41)

Catheterization of the umbilical artery is probably always

associated with some degree of reversible damage to the

arterial intima (42,43).

1. Malpositioned catheter (Figs. 29.14–29.16)

a. Vessel perforation (44)

b. Refractory hypoglycemia with catheter tip opposite

celiac axis (45)

c. Peritoneal perforation (46)

d. False aneurysm (47)

e. Movement of catheter tip position because of

changes in abdominal circumference