Why do umbilical lines help infants in respiratory stress?

[LucyRn4]

Hi all

I am a relatively new NICU nurse. I am trying to understand why doctors order line placements when an infant is in RDS and can't maintain their sats? Does it have anything to do with the fluids they are getting through the lines? Any insight will help. Thank you!

Lucy

[prmenrs, RN]

Umbi lines are the easiest way to get fluids, antibiotics, etc., going as soon as possible. Arterial lines can be used to monitor the BP, and obtain labs including arterial blood gases to manage the baby's ventilator in response to his/her needs. Peripheral lines can be harder to start, but will still be needed.

[Isabelle49]

If I remember correctly, the umbilical line being a central line can handle a higher concentration of dextrose, so that the infant can get required dextrose without too much volume. And, there is a very very small chance that the lines could infiltrate. BTW Dopamine cannot be given peripherally, at least it couldn't when I was an NICU nurse.

[LucyRn4]

Thank you for your responses

[Jory, MSN, APRN, CNM]

Umbilical lines, by rule of thumb, are only good for about 7 days, but sometimes if the baby is super early (23 weeks, etc), they will leave them in longer, but a kid has to either be really small or sicker than spit before they will not remove it.

However, the best practice is to remove the umbilical lines by 7 to 8 day so that the umbilical area may close and heal, then PICC placement or a radial art line for blood draws is preferable.

[meanmaryjean, DNP, RN]

They are just a means of intravenous/ arterial access. It has nothing to do with the diagnosis per se- you would place one for any number of conditions. They are easy and fast to place as well.

[labordude, BSN, RN]

If I remember correctly, the umbilical line being a central line can handle a higher concentration of dextrose, so that the infant can get required dextrose without too much volume. And, there is a very very small chance that the lines could infiltrate. BTW Dopamine cannot be given peripherally, at least it couldn't when I was an NICU nurse.

It is certainly not ideal, but Dopamine can be (and is) given peripherally if no central access is available. I always try to have a second line available when I am giving it this way in case you get severe vasoconstriction or are pushing/bolusing/infusing other drugs at the same time. It's also ideal to have it running at a good consistent clip with compatible drugs whose rates will not be changing (TPN, D5W, etc)