Skip to Main Content




  1. Frequent or continuous measurements of arterial blood gases.

  2. Continuous arterial blood pressure monitoring.

  3. Access for exchange transfusion (to withdraw blood).

  4. Angiography.

  5. Administration of emergency resuscitation medications and fluids. Note: Umbilical vein preferred.

  6. Infusion of maintenance solutions.

  7. Short-term infusion/emergency infusion of volume expanders, parenteral nutrition, and/or medications (controversial). Parenteral nutrition can be given through a UAC, a route that has been used in some centers, especially in very low birthweight (VLBW) infants; however, the umbilical artery is not preferred and should be used with caution. The maximum dextrose concentration that can be administered using this method is 15%. If necessary, antibiotics can be given via UAC, but this also is not a preferred method. Indomethacin, vasopressor medications (epinephrine, dopamine, dobutamine), calcium boluses, and anticonvulsants should not be given via the UAC (umbilical venous catheter [UVC], central venous line preferred).

  8. Blood products (controversial, emergency only). Blood products can be given via a UAC, but UVC or peripheral/central access preferred. UAC is less preferred, as this may enhance the risk of thrombosis.




  1. Basic. Prepackaged umbilical artery catheterization trays (usually include sterile drapes, tape measure, a needle holder, suture scissors, hemostat, forceps, scalpel, 3-way stopcock), umbilical tape, silk tape (eg, Dermicel), 3–0 silk suture, gauze pads, antiseptic solution, sterile gown, gloves, mask, hat, 10-mL syringe, 0.5% normal saline (NS) flush solution (0.25% NS for very small infants to decrease hypernatremia risk), NS with heparin (0.25–1.0 U/mL) in continuous infusion calibrated pressure transducer for pressure monitoring. Ultrasound equipment is optional to guide catheter insertion.

  2. Umbilical artery catheter (sizes 2.5F, 3.5F, 5F, 12–15 inch). Size recommendations vary based on institutional guidelines. Some general guidelines:

    1. UAC recommendation 1. 2.5F if <800–1000 g, 3.5F >1000 g, 5F in a term infant.

    2. UAC recommendation 2. 3.5F if <1.2 kg or 1.5 kg, 5F for an infant weighing >1.2 or 1.5 kg.

    3. If using catheter without a hub. Cut off wide part of catheter and insert blunt needle: No. 18 for 5F, No. 20 for 3.5F.

    4. Single-lumen UAC recommended. Multiple-lumen catheters are not recommended (recommended for UVC use only). End-hole catheters are associated with a decreased risk of aortic thrombosis when compared with side-hole catheters. Avoid side-hole catheters.

    5. Feeding tubes used as catheters. Associated with increase in thrombosis; avoid use.

    6. Cochrane review notes that there is no benefit of using a heparin bonded polyurethane catheter versus the standard polyvinyl chloride (PVC) catheter. A catheter made of Silastic (silicone) is more difficult to use because it is softer but may reduce aortic thrombosis compared with PVC tubing. Teflon or polyurethane catheters have been associated with fewer infections and thrombogenicity than PVC or polyethylene catheters.




  1. Important UAC tips

    1. The 2 umbilical arteries (1 umbilical artery in ∽1% of births) are muscular walled vessels (2–3 mm) that carry deoxygenated blood from the fetus to the placenta. The umbilical arteries are the direct continuation of the internal iliac arteries. The catheter enters the umbilical artery at the ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPediatrics Full Site: One-Year Subscription

Connect to the full suite of AccessPediatrics content and resources including 20+ textbooks such as Rudolph’s Pediatrics and The Pediatric Practice series, high-quality procedural videos, images, and animations, interactive board review, an integrated pediatric drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPediatrics

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.