Double Volume Exchange Transfusion Clinical Pathway, ICU – Assess Vascular Access

Double Volume Exchange Transfusion Clinical Pathway — ICU

Assess Vascular Access

If unable to obtain arterial access before blood arrives at bedside, use Venous Access Only procedure.

Access Considerations
Umbilical Venous Catheter (UVC)
  • UVC exchange kits contain 5 Fr and 7 Fr single lumen catheters with side holes that aid ease of blood withdrawal
  • If existing UVC not in place, use a catheter from the kit
  • If using double lumen UVC, use larger lumen
  • Ideal to have the largest lumen catheter based on size of infant
  • Location of UVC
    • RA/IVC junction — confirm not extending into RA via X-ray
    • Low lying — inserted 2–4 cm of depth beyond umbilical stump
UVC and Umbilical Arterial Catheter (UAC)
  • If using double lumen UVC, use larger lumen
  • Slightly faster procedure
  • Straightforward setup
Peripheral Intravenous Catheter (PIV)
Peripherally Inserted Arterial Catheter (PIA)
  • Larger catheters are preferred
  • Increased risk of losing access during procedure (troubleshooting)
  • Minimum of 2 PIVs are needed
    • Transfusion and maintenance fluids/medications