Randomised trial of umbilical arterial position: Doppler ultrasound findings

Abstract

Umbilical arterial catheters (UAC) were randomly assigned in 69 infants to a high (n=36) or to a low (n=33) position. Serial Doppler ultrasound measurements of blood flow velocity in their superior mesenteric arteries, coeliac axis, renal arteries, and anterior cerebral arteries were then obtained. There were no differences in blood flow velocity between high and low UAC groups on days 1, 3, and 7. At 2 weeks, those infants with a high UAC still in place had significantly higher velocities in the mesenteric artery than those infants who had no catheter in place. Infants with high UACs remaining in place for more than 7 days were found to have an increase in abdominal distension and tenderness, whereas this was not the case for those with low UACs. Catheter position has no effect on visceral blood flow if the UAC stays in place for one week or less, whereas prolonged use of a high UAC may alter intestinal blood flow and increase the incidence of abdominal symptoms.