A) The vein may remain patent up to 10-14 days of life
Neonates that have been discharged home and return within the first 1-2 weeks of life (especially the first week) and need emergent vascular access can have an umbilical vein catheterization attempt. However, if placement attempts are taking a long time, intraosseous access should be obtained. The cord may need to be moistened if it is dried. There are 2 muscular small umbilical arteries and one thin-walled larger vein. The formula provided is for umbilical artery access; umbilical vein catheters are typically placed 3-5cm just until a flash of blood return is obtained. Placing them too far risks hepatic damage. The catheter can be used as any other vascular access to withdraw blood for testing and to infuse any medication including epinephrine.
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September 24, 2024 at 5:26 pm
A) The vein may remain patent up to 10-14 days of life
Neonates that have been discharged home and return within the first 1-2 weeks of life (especially the first week) and need emergent vascular access can have an umbilical vein catheterization attempt. However, if placement attempts are taking a long time, intraosseous access should be obtained. The cord may need to be moistened if it is dried. There are 2 muscular small umbilical arteries and one thin-walled larger vein. The formula provided is for umbilical artery access; umbilical vein catheters are typically placed 3-5cm just until a flash of blood return is obtained. Placing them too far risks hepatic damage. The catheter can be used as any other vascular access to withdraw blood for testing and to infuse any medication including epinephrine.