Percutaneous femoral arterial and venous catheterisation during neonatal intensive care

Background-Femoral vessel catheterisation is generally avoided in the neona tal period because of technical difficulties and the fear of complications. Aim-To review the use of femoral arterial and venous catheters inserted per cutaneously on the neonatal intensive care unit. Methods-Infants admitted to one of two regional neonatal intensive care uni ts who underwent femoral vessel catheterisation were identified. Informatio n collected included basic details, indication for insertion of catheter, t ype of catheter and insertion technique, duration of use, and any catheter related complications. Results-Sixty five femoral catheters were inserted into 53 infants. The med ian gestational age was 29 weeks (range 23-40). Twenty three femoral arteri al catheters (FACs) were inserted into 21 infants and remained in situ for a median of three days (range one to eight). Twelve (52%) FACs remained in place until no longer required, and four (17%) infants developed transient ischaemia of the distal limb. Forty two femoral venous catheters (FVCs) wer e inserted into 40 infants and remained in situ for a median of seven days (range 1-29). Twenty seven (64%) FVCs remained in place until no longer req uired, and eight (19%) catheters were removed because of catheter related b loodstream infection. Conclusions-FACs and FVCs are useful routes of vascular access in neonates when other sites are unavailable. Complications from femoral vessel cathete risation include transient lower limb ischaemia with FACs and catheter rela ted bloodstream infection.