Umbilical Artery Catheter Question

[Tiki_Torch]

How long does your unit generally leave UAC's in? Do you ever use radial artery lines?

My previous NICU left UAC's in for no longer than 5 days and then the baby got a radial artery line if they still needed arterial blood gases. My new place keeps the UACs in until they are no longer needed for ABGs or until they stop working well... can be up to 3 weeks sometimes... and I've only seen two babies with radial artery lines in the past 3 years. We don't have a high incidence of infection or injury related to keeping the UACs in place for so long as far as I can tell.

Just wondering what other units do.

Also, does anyone know of any research articles that speak to a safe length of time to leave UACs in place?

Thanks,

Tiki

[BittyBabyGrower, MSN, RN]

Usually the max for us is 7-10 days. But if a kid is really, really sick or very tiny, we will leave them in for as long as we can. Usually sepsis isn't a problem, but we are concerned over clots, it seems that these kids will have high blood pressures after they are removed and some do have microthrombi or bigger clots. It is like you are between a rock and a hard place KWIM? We don't use peripherals too often, only if we can't get in a line.

[cathys01]

We keep our UAC's about 7 days on average and we do tend to use a lot of PALs.

[Gompers, BSN, RN]

We usually leave umbilical lines in for a week, give or take a few days. After that, they get PCVCs and PALs if necessary. We use PALs very often. If the baby is unstable as far as blood gasses or blood pressures go, we'll put in a PAL. When a formerly stable baby gets sick or has surgery, we do the same thing. I've never seen a baby have a bad outcome from a PAL - we remove them as soon as we see a problem and the limb recovers. We do radial art lines mostly, but sometimes we'll have them in the ankles if necessary.

[tracy6fan]

The CDC's website is a good place to start when you're looking for various practice recommendations. www.cdc.gov It's often difficult to find full text articles on the web unless you're a member.

We leave our UACs in for 5-7 days. CDC says 5 or fewer days is optimal. Also use alot of PALs until they don't work any more or don't need them.

[jnsatc]

We leave our UAC's in as long as they continue to work. I've seen them left in over three 3wks sometimes. I've not noticed an increased rate of infection or cloting. We don't use radial lines. Once we remove the UAC's we try to place midlines, otherwise we use peripheral lines unfortunately.