Lower extremity ischemia following umbilical artery catheterization: A case study and clinical update

In the neonatal intensive care unit, the use of umbilical artery catheters (UAC) is established. Methods to perform uninterrupted arterial blood gas and pressure monitoring, access for the delivery of fluids and medication, exchange transfusion, cardiac catheterization, and angiography using umbilical artery catheters are used in the care of critically ill neonatal patients. One complication that can develop with the use of UAC's is lower limb ischemia, which can result in catastrophic effects, including limb amputation. In selected cases, conservative management may be an option in patients for limb salvage in the setting of lower limb ischemia. In this paper, we present a case study of a patient who developed lower limb ischemia during UAC who was treated conservatively. This approach resulted in limb salvage and avoidance of lower extremity amputation. The literature was reviewed for relevant risk factors and treatment options for lower limb ischemia following umbilical artery catheterization.