Measurement of the ‘Shoulder-Umbilical’ Distance for Insertion of Umbilical Catheters in Newborn Babies: Questionnaire Study

Abstract

Approximately 40 years ago, Dr. Peter Dunn introduced a simple method to determine the insertion length of umbilical catheters in neonates, by using the ‘shoulder-umbilical’ (S-U) length. Since then, various studies have reported a high rate of malposition of umbilical catheters. One of the possible reasons is that the method used to determine the S-U length varies among paediatric professionals. We performed a questionnaire study among 101 paediatric professionals in the Netherlands and found that the method used by the participants to measure the S-U length was highly inconsistent. Placement of an umbilical venous catheter in a too deep position may lead to potentially life-threatening complications. Therefore, uniformity in measurement is paramount for clinical and teaching purposes. Paediatric professionals using Dunn’s definition to place umbilical catheters should adhere more strictly to the original description of the measurement of the S-U length.

Estimating umbilical catheter insertion depth in newborns using weight or body measurement: a randomised trial

“…While the shoulder-umbilicus length is frequently used to estimate the insertion depth of umbilical catheters, it appears that many clinicians do so incorrectly. A survey of 101 paediatric doctors, including 45 consultant paediatricians, showed that only 14/101 (14%) used the measurement described by Dunn correctly 30. Our results should be extrapolated with caution if the shoulder-umbilicus length is measured incorrectly.…”

Ultrasound-guided umbilical catheter insertion in neonates

“…[3][4][5] Several studies have questioned the current methods used for estimating umbilical catheter insertion length. Lopriore et al 6 questioned 101 pediatric professionals from 6 centers in the Netherlands and found that the method used by the participants to measure the shoulder-umbilicus length was highly inconsistent, with only 14% using the described measurement. BW-based methods that are widely used in the United States do not predict catheter placement as accurately in smaller preterm infants.…”

Use of the Recanalised Umbilical Vein for Islet Autotransplantation following Total Pancreatectomy

“…All these approaches required the patient to remain anaesthetised during the islet delivery and repeated infusions were not feasible as the veins could not be safely exteriorised for prolonged periods even using an omental tube. The umbilical vein as a method of portal venous access has been long used for total parenteral nutrition in neonates (where the vein is still patent) or occasionally in adults with difficult vascular access problems [18]. The use of the recanalised umbilical vein overcame the obstacles associated with the middle or right colic vein.…”