Unexpected Ischemia: A Case of Neonatal Ulcer After Umbilical Artery Catheter Calcium Gluconate Infusion

Umbilical artery catheterization is a widely used method for gaining access to arterial circulation in critically ill neonates and is performed in as many as 2% of all births. Although umbilical artery catheters offer many advantages, including convenient administration of fluids and medications, arterial blood sampling, and arterial blood pressure monitoring, their use may pose unknown risks. A case of buttock ulcer is reported in a full-term infant after umbilical artery catheterization. Some of the possible causes of this unforeseen complication are discussed. Concerns regarding potential deleterious effects of intra-arterial injection of calcium gluconate on skin viability are raised, and caution is recommended when administering calcium gluconate via umbilical artery catheter.