DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20214712
Published: 2021-11-26

A cross sectional study assessing six different methods to predict the ideal position of umbilical venous catheters in neonates of different weight categories

Nida Janna V. K., Serena Mohan Varghese, Madhu George, Susan John

Abstract


 

Background: This was  a cross sectional study  done to find the most suitable method of assessing umbilical venous catheter (UVC)  length in seventy two neonates of four different weight categories using  six methods.

Methods: Neonates were grouped into A (upto 1 kg), B (>1-1.5 kg), C (>1.5-2.5 kg) or  D (>2.5 kg)  based on their birth weight. UVC was placed using Shukla-Ferrara method and x-ray taken to finalize the catheter length. The predicted catheter length was also measured by  Dunn method, umbilicus to nipple length, umbilicus to xiphisternum length, umbilicus to midpoint of inter mammary distance, and umbilicus to symphysis pubis length. ANOVA test was used to find the methods which did not have statistically significant difference with the final length from x-ray (p>0.5). The method with the least mean difference from final length was taken as the most suitable.

Results: UVC length assessed by Shukla Ferrara method and umbilicus to midpoint of inter mammary distance did not have statistically significant difference with final catheter length on x-ray in all groups. UVC length assessed by Dunn method did not have statistically significant difference with final catheter length on x-ray in group A, C and D while UVC length assessed by umbilicus to nipple length did not have statistically significant difference in group D.

Conclusions: Umbilicus to the midpoint of inter-mammary distance was the most suitable method to estimate length of insertion of UVC in neonates.

 


Keywords


Dunn method, Shukla Ferrara method, Umbilicus to midpoint of inter-mammary distance, Umbilicus to nipple length, Umbilicus to symphysis pubis length, Umbilicus to xiphisternum length

Full Text:

PDF

References


Rajani AK, Chitkara R, Oehlert J, Halamek LP. Comparison of umbilical venous and intraosseous access during simulated neonatal resuscitation. Pediatrics. 2011;128(4):e954-8.

Lewis K, Spirnak PW. Umbilical Vein Catheterization. In: StatPearls. Treasure Island (FL). StatPearls Publishing; 2021.

Goodarzi R, Tariverdi M, Khamesan B, Barchinejad M, Zare SH, Mehdi HM. Dunn and Shukla Methods for predicting length of umbilical catheter in newborns. Asian J Med Pharm Res. 2014;4(2):85-133.

Green C, Yohannan MD. Umbilical arterial and venous catheters: placement, use, and complications. Neonat Network. 1998;17(6):23-8.

Vali P, Fleming SE, Kim JH. Determination of umbilical catheter placement using anatomic landmarks. Neonatology. 2010;98(4):381-6.

Sherwani P, Vire A, Anand R, Jajoo M. Umbilical venous catheterization gone wrong: Hepatic complications. Indian J Radiol Imag. 2016;26(1):40-3.

Chinnaswamy K, Chandramohan A, Kadirvel K, Palanisamy S. Incidence of complications following umbilical vein catheterisation in neonates. Int J Contemp Pediatr. 2019;6(5):1863-66.

Gupta AO, Peesay MR, Ramasethu J. Simple measurements to place umbilical catheters using surface anatomy. J Perinatol. 2015;35(7):476-80.

Sengupta A, Lehmann C, Diener-West M, Perl TM, Milstone AM. Catheter duration and risk of central line-associated bloodstream infection in neonates with PICCs. Pediatrics. 2010;125(4):648-53.

Narla LD, Hom M, Lofland GK, Moskowitz WB. Evaluation of umbilical catheter and tube placement in premature infants. RadioGraphics. 1991;11(5):849-63.

Shukla H, Ferrara A. Rapid estimation of insertional length of umbilical catheters in newborns. Am J Dis Child. 1986;140(8):786-8.

Dunn PM. Localization of the umbilical catheter by post-mortem measurement. Arch Dis Child. 1966;41(215):69-75.

Kieran EA, Laffan EE, O’Donnell CPF. Estimating umbilical catheter insertion depth in newborns using weight or body measurement: a randomised trial. Arch Dis Child Fet Neonat Ed. 2016;101(1):F10-5.

Mutlu M, Aslan Y, Kul S, Yılmaz G. Umbilical venous catheter complications in newborns: a 6-year single-center experience. J Matern Fet Neonat Med. 2016;29(17):2817-22.

Verheij GH, te Pas AB, Witlox RSGM, Smits-Wintjens VEHJ, Walther FJ, Lopriore E. Poor accuracy of methods currently used to determine umbilical catheter insertion length. Int J Pediatr. 2010;2010:873167.

Sheta A, Kamaluddeen M, Soraisham AS. Umbilical venous catheter insertion depth estimation using birth weight versus surface measurement formula: a randomized controlled trial. J Perinatol. 2020;40(4):567-72.

Krishnegowda S, Thandaveshwar D, Mahadevaswamy M, Doreswamy SM. Comparison of JSS formula with modified shukla’s formula for insertion of umbilical venous catheter: a randomized controlled study. Indian Pediatr. 2019;56(3):199-201.