Umbilical artery catheterization is a procedure used in neonatal intensive care units (NICUs) for monitoring intravascular pressures, chemistries, blood gases, and for administering fluids and medications. Multiple complications can result from this procedure, the most common of which is thrombosis. Cutaneous manifestations of the complications can help direct prompt treatment.

Thromboses can result in multiple cutaneous findings. Early changes include reticulated erythema, transient blanching, vesicles, and bulla. They can progress to unilateral or bilateral gangrene of the feet, lower extremities, or buttocks depending on the site of thrombus.

Rapid recognition of the complications is necessary to facilitate prompt removal of the catheter and treatment. Vasospasm occurring during placement of the catheter is manifest by temporary blanching or cyanosis of the leg and foot. The catheter should be promptly removed if this occurs.