Percutaneous femoral arterial and venous catheterisation during neonatal intensive care.
BACKGROUND
Femoral vessel catheterisation is generally avoided in the neonatal period because of technical difficulties and the fear of complications.


OBJECTIVE
To review the use of femoral arterial and venous catheters inserted percutaneously on the neonatal intensive care unit.


METHODS
Infants 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.


RESULTS
Sixty 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.


CONCLUSIONS
FACs 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.
Wardle
S P
SP
Department of Child Health, University of Liverpool, Liverpool Women's Hospital, Liverpool, UK.
Kelsall
A W
AW
Yoxall
C W
CW
Subhedar
N V
NV
D016470:Bacteremia / Q000209:etiology; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005263:Femoral Artery; D005268:Femoral Vein; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods*; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply