Rapid Estimation of Insertional Length of Umbilical Catheters in Newborns

Shukla, Harikrishna; Ferrara, Angelo

doi:10.1001/archpedi.1986.02140220068034

Cited by 71 publications

(84 citation statements)

References 12 publications

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“…Two of the most common methods used to guide catheter insertion length are the shoulder-umbilicus length graph 1 and a regression equation based on birth weight (BW). 2 In these methods, catheters are inserted and advanced blindly to the predetermined length from the umbilicus. Both anterior-posterior and lateral radiographs are taken after placement of the catheters to check the adequacy of catheter positioning.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided umbilical catheter insertion in neonates

Fleming

Kim

2011

J Perinatol

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Objective: Umbilical catheter placement is a routine neonatal emergency procedure that has large variability in technical methods. Commonly used methods are unable to accurately estimate insertion lengths, and X-rays cannot always identify malpositioned catheters. In clinical practice, the placement of umbilical lines takes time away from nursing during a critical transition period. Ultrasound is a safe and commonly used tool in the nursery for clinical management of sick neonates and has been shown to readily identify central catheter tip position. In this study, we sought to determine a more time-efficient and accurate means of umbilical catheter placement using bedside ultrasound.Study Design: This is a prospective, randomized, pilot trial of infants of any age or weight admitted to the neonatal intensive care unit who required umbilical catheter placement. Infants were excluded if they had congenital heart disease, abdominal wall defects or had a single umbilical artery. Catheters were placed using either the conventional method, with blinded evaluation of the catheters using ultrasound, or with ultrasound guidance, with input pertaining to catheter tip location. The number of X-rays required to confirm proper positioning, completion time points throughout the procedure and manipulations of the lines were recorded for both groups.Result: Ultrasound use decreased the time of line placement with an average saving of 64 min, as well as decreased the number of manipulations required and X-rays taken to place the catheters. The average X-ray time from request to viewing per X-ray was 40 min for all subjects.Conclusion: Ultrasound-guided umbilical catheter placement is a faster method to place catheters requiring fewer manipulations and X-rays when compared with conventional catheter placement.

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Section: Introductionmentioning

confidence: 99%

Ultrasound-guided umbilical catheter insertion in neonates

Fleming

Kim

2011

J Perinatol

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“…Two of the most common methods used to guide insertion length based on these studies are the shoulder-umbilicus length graph and a regression equation based on birth weight. 11,12 Antero-posterior (AP) chest radiography (CXR) is the most common method used to confirm appropriate UVC position; lateral CXR, venous pressure monitoring, and blood gas analysis may also be utilized. However, several studies question the validity of these common methods used for estimating correct catheter insertion length and final anatomic position.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Evaluation of Umbilical Venous Catheter Placement

et al. 2003

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“…17 infants had respiratory distress syndrome, three had persistent pulmonary hypertension of the newborn, one had pneumonia, one had pulmonary hypoplasia, one hypoxic-ischemic encephalopathy, one congenital heart disease and one epidermolysis bullosa. The proper insertion of the catheter was achieved by using the formula developed by Shukla and Ferrara [10], aiming the tip of the catheter in the right atrium, i.e. just above the diaphragm as seen on the Xrays.…”

Section: Methodsmentioning

confidence: 99%

Double-Catheter Technique for the Proper Insertion of Umbilical Venous Catheters in Newborns

Al-Essa

Rashwan²,

Devarajan

2005

Med Princ Pract

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Objectives: To document the usefulness and safety of inserting a second umbilical venous catheter in ill neonates, while a previously misplaced first catheter was still in its place. Subjects and Methods:The case series involved 25 newborn babies who were admitted to the Neonatal Intensive Care Unit, Maternity Hospital, Kuwait, over a 3-year period from 1999 to 2002. The umbilical venous catheter of the babies was misplaced and diverted to the liver, necessitating insertion of a second catheter while the previous one was still in place. The characteristics of the babies and possible catheter-related complications were recorded. Results:Of the 25 babies, 19 had the second catheter properly placed in the right atrium, while in the remaining 6 neonates, the catheter was still misplaced. Misplacement occurred mostly in full-term babies or the catheter was inserted at a later stage. No life-threatening complication was observed during the procedure. Conclusion:Insertion of a second umbilical venous catheter with the misplaced first catheter in situ is a useful and safe procedure.

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Rapid Estimation of Insertional Length of Umbilical Catheters in Newborns

Cited by 71 publications

References 12 publications

Ultrasound-guided umbilical catheter insertion in neonates

Ultrasound-guided umbilical catheter insertion in neonates

Echocardiographic Evaluation of Umbilical Venous Catheter Placement

Double-Catheter Technique for the Proper Insertion of Umbilical Venous Catheters in Newborns

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