ABSTRACT
Advancements in monitoring, ventilatory support, vascular access, and maintenance of core body temperature have been paramount in the vast increase in survival rates of newborns. Invasive access to the arterial system has been a mainstay in the monitoring of the critically ill patient for decades. Most complications with peripherally inserted arterial catheters arise due to thromboembolic events or vasospasm. Umbilical artery catheters (UACs) placement is contraindicated in infants with omphalocele, omphalitis, umbilical cord anomalies, necrotizing enterocolitis, or signs of peritonitis or lower extremity vascular compromise. The most common site for peripheral arterial access is the radial artery. It provides a site that is ideal to access due to its consistent anatomical relationships, collateral blood flow, and easy access for nursing maintenance. The majority of centrally placed lines in most neonatal units are peripherally inserted central catheter (PICC) lines. These lines can be quickly placed by specially trained nursing personnel, radiologists, or pediatric surgeons at bedside with little to no sedation.
