What is the purpose of a umbilical arterial catheter (UAC) placement and one major complication to monitor for?

• A. UAC provides arterial access for blood sampling and continuous blood pressure monitoring; Major complication: arterial thrombosis leading to limb ischemia.
• B. UAC provides venous access for blood sampling.
• C. UAC rarely has complications.
• D. Major complication: easy removal.

Answer: (A)

UAC placement gives arterial access for frequent blood sampling and continuous arterial blood pressure monitoring. In critically ill neonates, reliable central arterial pressure readings and easy sampling of arterial blood gases help guide treatment without repeated punctures of peripheral vessels.

A major complication to monitor for is arterial thrombosis leading to limb ischemia. The catheter can promote clot formation in the umbilical/descending aorta, cutting off blood flow to the lower extremities. Watch for signs of reduced perfusion in the leg—cool, pale or mottled skin, delayed capillary refill, weak or absent femoral/pedal pulses, or changing limb temperature. If suspected, reassess catheter position and consider removal or repositioning and urgent vascular evaluation as needed.