Article Text

OCCURRENCE, PLACEMENT AND COMPLICATIONS OF ARTERIAL CATHETERISATION IN POLISH NEONATAL CENTRES
  1. J Swietlinski1,
  2. J Zejda2,
  3. G Brozek2,
  4. E Swietlinska2,
  5. J Ksiazyk1,
  6. M Migdal1
  1. 1The Children’s Memorial Health Institute, Warsaw, Poland
  2. 2Medical University of Silesia, Katowice, Poland

Abstract

Objective The goal of the study was to examine arterial catheterisation practices in Polish neonatal centres.

Methods The study was performed in 2006 within the frames of the National Survey on Neonatal Practices and Procedures. 315 (75%) questionnaires were returned and included in the analyses. Data analysis was done using SAS statistical software.

Results Arterial catheterisation is performed in 53 (16.8%) centres, most frequently in highest reference 68.0%, compared with 34.7% and 5.7% in medium and in lowest reference level centres, respectively (p<0.0001). The frequency of arterial catheterisation increases with the number of admissions (p<0.0002). A major indication for arterial catheterisation is blood sampling, either alone or together with blood pressure measurement. The umbilical route is the most frequent access for arterial catheterisation, followed by radial artery. The second access is the most frequent choice in the centres of the highest reference level. Written instructions on arterial catheterisation are available in 66% of centres; however, placement is documented in medical files in only 56%. No significant differences were found in centres with different reference levels. The average time of cannulation is 3.2 ± 2.5 days. The list of complications of arterial catheterisation included necrosis of a limb, local necrosis, transient perfusion impairment and local purulent changes. Only three centres reported frequent occurrence of transient perfusion impairment, otherwise all reported complications were classified as sporadic (“seldom”). Any of the above-mentioned events occurs in 48 out of 53 centres (90.5%).

Conclusions Arterial catheterisation is a common procedure, with a moderate complication rate. Lack of proper documentation for arterial catheterisation should be a point for improvement.

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