Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

Lean, Wei Ling; Dawson, Jennifer A; Davis, Peter G; Theda, Christiane; Thió, Marta

doi:10.1136/archdischild-2017-313039

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Similarly, the accuracy of UAC placement increased considerably from 33.3-83.8% when RT-US was used instead of Shukla's formula. Previous investigations reported an accuracy of Shukla's formula ranging from 52.4-91% for UAC insertion [15,16,[18][19][20]. However, research on US-guided UAC placement is scarce.…”

Section: Discussionmentioning

confidence: 99%

“…The results of multiple investigations, including our own, indicate that the methods currently used for calculating the length of umbilical catheter insertion are not accurate [9,11,[15][16][17][18][19][20] Therefore, we developed an equation (linear regression) using the data from our study on the optimum catheter length (not including the umbilical stump length) in relation to the neonate's birth weight to predict the length of umbilical catheters. The equations for the UVC and UAC are as follows: UVC length (cm) = birth weight (kg) + 5.26 (R 2 = 0.63, p < 0.001) and UAC length (cm) = 2 × birth weight (kg) + 9.60 (R 2 = 0.79, p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

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Real-time ultrasound to assess the umbilical catheter position in neonates: a randomized, controlled trial

Ruangkit,

Ponin,

Ruangwattanapaisarn

et al. 2024

Preprint

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Objective To compare real-time ultrasound (RT-US) use as an adjunct tool to verify umbilical catheter placement versus standard care without ultrasound. Study Design: Neonates requiring umbilical venous catheter (UVC) and umbilical artery catheter (UAC) placement were randomized into the standard formula (No-US) and the RT-US groups. X-rays were used to confirm the catheter position. Result Fifty and forty-nine neonates were in the RT-US and No-US groups, respectively. RT-US showed a significantly higher rate of initial X-ray-confirmed proper catheter position than No-US (p < 0.001). The rates of proper positions of UVCs and UACs were significantly higher in the RT-US group than in the No-US group (both p < 0.001). Neonates in the RT-US group required fewer catheter adjustments and subsequent X-rays than those in the No-US group. Conclusion RT-US enhances the accuracy of UVC and UAC placement, reduces catheter adjustments, and the number of X-rays required. Trial Registration TCTR20190622001

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-time ultrasound to assess the umbilical catheter position in neonates: a randomized, controlled trial

Ruangkit,

Ponin,

Ruangwattanapaisarn

et al. 2024

Preprint

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“…Umbilical artery catheterization has become a commonly performed procedure in the NICU and in the care of extremely preterm neonates [ 38 , 39 ]. It should be inserted only in critically ill infants [ 6 ].…”

Section: Umbilical Arterial Catheterization (Uac)mentioning

confidence: 99%

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Zubi,

Abdullah,

Helmi

et al. 2023

International Journal of Pediatrics

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About 10% of newborns require some degree of assistance to begin their breathing, and 1% necessitates extensive resuscitation. Sick neonates are exposed to a number of invasive life-saving procedures as part of their management, either for investigation or for treatment. In order to support the neonates with the maximum possible benefits and reduce iatrogenic morbidity, health-care providers performing these procedures must be familiar with their indications, measurements, and potential complications. Hence, the aim of this review is to summarise ten of the main neonatal intensive care procedures with highlighting of their indications, measurements, and complications. They include the umbilical venous and arterial catheterizations and the intraosseous line which represent the principal postnatal emergency vascular accesses; the peripherally inserted central catheter for long-term venous access; the endotracheal tube and laryngeal mask airway for airway control and ventilation; chest tube for drainage of air and fluid from the thorax; and the nasogastric/orogastric tube for enteral feeding. Furthermore, lumber puncture and heel stick were included in this review as very important and frequently performed diagnostic procedures in the neonatal intensive care unit.

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“…Formulas to determine umbilical catheter insertion length exist. However, none of these guarantee correct placement [3, 4] and evaluation before use is necessary. The current standard for the assessment of umbilical catheter tip position is anterior-posterior X-ray with or without lateral projection of the neonate’s chest and abdomen [5].…”

Section: Introductionmentioning

confidence: 99%

Learning Curves for Training in Ultrasonography-Based Examination of Umbilical Catheter Placement: A Piglet Study

et al. 2019

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Background: The training required for accurate assessment of umbilical catheter placement by ultrasonography (US) is unknown. Objective: To describe the learning curve and provide an estimate of the accuracy of physicians' US examinations (US skills) and self-confidence when examining umbilical catheter tip placement. Methods: Twenty-one physicians with minimal experience in US completed a 1.5-hour eLearning module. Ten piglets with catheters inserted in the umbilical vessels were used as training objects. Following eLearning each physician performed up to twelve 10-min US examinations of the piglets. Expert examinations were reference standards. Sensitivity and specificity of physicians' skills in detecting catheter tip placement by US was used to describe the learning curve. Self-confidence was reported by Likert scale after each examination. Results: Physicians' detection of a correctly placed and misplaced umbilical artery catheter tip increased by an odds ratio of 1.6 (95% CI: 1.1, 2.3) and 3.6 (95% CI: 1.7, 7.8) per examination performed. A sensitivity of 0.97 (95% CI: 0.80, 0.99) and specificity of 0.95 (95% CI: 0.84, 0.99) was reached after 6 examinations. For the venous catheter, US skills in detecting a misplaced catheter tip increased with an odds ratio of 2.4 (95% CI: 1.2, 4.8) per US examination. Overall, performance and self-confidence plateaus were reached after 6 examinations. Conclusion: We found steep learning curves for targeted US examination of umbilical catheter placement. eLearning followed by 6 examinations was found to be adequate training to perform with a sufficiently high accuracy and self-confidence to allow for point-of-care use.

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Accuracy of 11 formulae to guide umbilical arterial catheter tip placement in newborn infants

Abstract: Success rates for accurate UAC placement are highest when formulae that involve body measurements are used. However, even the most accurate method would result in more than 25% of UACs needing manipulation to achieve an optimal position.

Cited by 7 publications

References 22 publications

Real-time ultrasound to assess the umbilical catheter position in neonates: a randomized, controlled trial

Real-time ultrasound to assess the umbilical catheter position in neonates: a randomized, controlled trial

Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Learning Curves for Training in Ultrasonography-Based Examination of Umbilical Catheter Placement: A Piglet Study

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