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J Pediatr Intensive Care
DOI: 10.1055/s-0042-1757476
Review Article

Complications of Peripheral Arterial Access in Preterm and Term Neonates: A Systematic Review

Yangmyung Ma 
1   Department of Plastic Surgery, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom
,
Ahmed Salem
2   Department of Plastic Surgery, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
3   Department of Plastic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
,
Andrea Jester
2   Department of Plastic Surgery, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
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Abstract

The aim of the study is to provide a comprehensive review of vascular complications secondary to peripheral arterial catheterization in preterm and term neonates. The systematic review consisted of searching PubMed, Scopus, Google Scholar, Cochrane Database of Systematic Reviews, and references of journals using pre-trialed MeSH terms and articles. Eight studies were included for full text analysis from 2,369 initial articles: six retrospective reviews and two prospective studies. Rate of complication was 8.6% and all complications were ischemic in nature. Complications most often occurred in neonates with pulmonary/cardiac comorbidities and lower gestational ages. No association was found for weight and sex of neonates. The radial artery site presented with lower rates of complication of 6% and the femoral presented with the highest (16%). Complications predominately occurred in catheter sizes larger than 22 gauge and most often within 1 day of insertion. A low rate of complications (7.4%) was observed in studies that used heparinized saline at the time of catheterization. This study demonstrates an increasing overall rate of complications with ischemia presenting as the most common complication. There seems to be an association between gestational age, comorbidities, site of catheter, size of catheter, and duration of catheter with such complications. This study also demonstrates the association between the use of heparinized saline and a reduction in rate of complications. The authors advocate for a national data collection tool of all pediatric arterial catheters and its complications to be able to analyze and work on best practice to minimize life changing iatrogenic complications.

Keywords

preterm - term - systematic review - peripheral arterial catheter - complications


Publication History

Received: 09 May 2022

Accepted: 19 August 2022

Article published online:
11 October 2022

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