1
|
Patel S, Shannon D, Eldridge W, El-Ters N, Hanford J, Walker T, Scheer A, Jones E, Linwood K, Aragon N, Dunscombe L, Gerbes J, Srinivasan N, Vachharajani A. Understanding umbilical venous catheter insertion practices through a prospective multicenter observational study. J Matern Fetal Neonatal Med 2021; 35:5043-5048. [PMID: 33530795 DOI: 10.1080/14767058.2021.1874908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To understand practices of umbilical venous catheter (UVC) insertion in tertiary level neonatal intensive care units (NICU) and investigate the outcomes of subsequent attempts following a failed initial attempt. STUDY DESIGN Prospective, multi-center observational study of UVC insertions at tertiary level NICUs between March 2019 and January 2020. RESULTS Of the 101 UVCs inserted at 4 centers, seventy-two (71%) were central at the first attempt and 50% were central at subsequent attempts. Patients with at least 1 failed attempt at insertion were less likely to have a centrally placed UVC (p = .009). Manipulations were less likely to be required when UVC was centrally placed during the first attempt. Maneuvers such as posterior liver mobilization used during insertion were likely to be associated with successful central placement of UVC (p = .0243). The time to complete the procedure was significantly less when the UVC was central at the first attempt (34.2 ± 20.2 vs 46.9 ± 33.8) (p = .0292). Gestational age, birth weight, and age of the baby at the insertion of the UVC, experience of the provider, and type of catheter were comparable among groups. The Shukla formula was most commonly used by providers to measure the depth of UVC placement. CONCLUSION Repetitive attempts and manipulations were less likely to be beneficial in the successful central placement of UVC in neonates. Additionally, repetitive attempts at insertion prolonged the overall duration of the procedure.
Collapse
Affiliation(s)
- S Patel
- Department of Pediatrics, University of Illinois at Chicago, Oak Park, IL, USA
| | - D Shannon
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - W Eldridge
- Department of Pediatrics, Saint Joseph Women's Hospital, Tampa, FL, USA
| | - N El-Ters
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - J Hanford
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - T Walker
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - A Scheer
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - E Jones
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - K Linwood
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - N Aragon
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - L Dunscombe
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - J Gerbes
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - N Srinivasan
- Department of Pediatrics, University of Illinois at Chicago, Oak Park, IL, USA
| | - A Vachharajani
- Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| |
Collapse
|