Evaluation of arterial catheter management in very preterm neonates: peripheral artery versus umbilical artery.

OBJECTIVES To evaluate whether peripheral arterial catheter management is more effective than umbilical arterial management in very preterm neonates. METHODS Thirty-eight very preterm neonates born in Fukushima Medical University Hospital between October 2008 and March 2010 were evaluated. A peripheral arterial catheter was inserted in 19 neonates (peripheral group) and an umbilical arterial catheter in the remaining 19 neonates (umbilical group). RESULTS The median gestational ages of the peripheral and umbilical groups were 195 and 185 days, respectively (p=0.04). The systolic and diastolic blood pressure (BP) was significantly higher in the peripheral group than in the umbilical group (p=0.03 and p=0.001). There was a significant relationship between BP at cannulation and urinary output after cannulation for 24 h in the peripheral group (r(s)=0.49, p=0.03); however, no such significant relationship was found in the umbilical group. CONCLUSIONS We considered that peripheral artery catheters provide a well-functioning route for continuous BP monitoring, even in very preterm neonates. Because umbilical catheter placement might affect urinary output, we speculated that peripheral arterial catheter placement would be a more effective management strategy than umbilical arterial catheter placement in very preterm neonates. Further studies of larger populations are necessary to evaluate the effectiveness of arterial management including long-term follow-up studies.