23.13 Umbilical Vessel Cannulation
Background
During fetal life, two umbilical arteries transport nutrients and oxygen from the placenta and one umbilical vein helps dispose of fetal waste. During delivery, these vessels are cut and clamped and the newborn is separated from the placenta. However, the umbilical vessels can be recannulated and utilised for emergent vascular access in ill neonates for up to 7 days after birth. This is an excellent method of central drug and fluid delivery, because peripheral venous access in infants in the first week of life is quite difficult, particularly in the ill or intravascularly depleted neonate. The other alternative for emergency vascular access in newborns is the insertion of an intraosseous needle (Chapter 23.11).
Equipment
Table 23.13.1 lists the equipment for cannulation of either the umbilical artery or vein.
