Intra-arterial infusions and intestinal necrosis in the rabbit: potential hazards of umbilical artery injections of ampicillin, glucose, and sodium bicarbonate.

Umbilical artery catheters are frequently employed for administration of medications. When the catheter tip is positioned adjacent to major aortic tributaries or inadvertently in the mesenteric arteries, high concentrations of infused substances may perfuse the intestine. Injections of saline, 50% dextrose, 10% dextrose, 8.4% sodium bicarbonate, and 100 mg/ml ampicillin were made into a branch of the mesenteric artery supplying 10 to 15 cm of rabbit ileum. The intestine was then examined two to five days later. All segments of intestine perfused with saline and 10% dextrose were grossly and microscopically normal. In each of the eight sites perfused with 50% dextrose, intestinal necrosis was noted (P less than .001). Four of eight sites perfused with ampicillin had hemorrhage and villus atrophy (p less than .001). Of the eight sites perfused with sodium bicarbonate, three had necrosis with hemorrhage and five had villus edema. The data indicate that intraarterial infusions of high concentrations of sodium bicarbonate, glucose, and ampicillin produce serious lesions in an animal model. This suggests that appropriate precautions should be exercised when administering medications through the umbilical artery catheter.