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'Pseudohypoxemia' Causing Temporary Mismanagement, due to Accidental Intraductal Placement of Umbilical Artery Catheter

MAYER SAGY, MD; MAYER OREN, MD; MICHAEL BRISH, MD
Am J Dis Child. 1982;136(2):170-171. doi:10.1001/archpedi.1982.03970380082018.
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The usefulness of the indwelling umbilical artery catheter in the treatment of critically ill newborns was established long ago. The need for precise monitoring of oxygen requirements to high-risk premature infants has made umbilical artery catheterization almost an obligatory procedure despite its known potential risks.1,2 A recent report has shown that placement of a catheter with its tip at T-7 to T-8 is associated with fewer episodes of blanching and cyanosis of the lower extremities than placement at a lower position.3

The premature infant described in this report was mismanaged for four hours because of accidental placement of the tip of the umbilical artery catheter in the ductus arteriosus. Blood samples obtained from the catheter for gas analysis yielded venous levels of Po2. By withdrawing the catheter by 4 cm, the expected arterial Po2 levels were encountered, and the fraction of inspired oxygen (Fio2) supplied

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