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Ultrasound-guided umbilical catheter insertion in neonates

Journal of Perinatology volume 31, pages 344–349 (2011)Cite this article

Subjects

Abstract

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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Acknowledgements

We thank all the healthcare professionals who helped with this study and all the parents of the participating study infants. This study was supported by a research grant from General Electric Healthcare. This paper was presented in poster presentation format at the Pediatric Academic Societies Annual Meeting in Baltimore, 5 May 2009.

Author contributions

All coauthors have read, approve of and concur with the submitted manuscript. All individuals designated as authors who made substantial contributions to the conception and design, execution, or analysis and interpretation of data, were involved in the drafting of the manuscript, and approved the manuscript as submitted.

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  1. Division of Neonatology, UCSD Medical Center, San Diego, CA, USA

    S E Fleming & J H Kim

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  1. S E Fleming
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  2. J H Kim
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Correspondence to J H Kim.

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The authors do not have commercial affiliation or consultant roles that could be construed as a conflict of interest. None of the original material contained in the manuscript has been previously published nor is currently under review for publication elsewhere.

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Fleming, S., Kim, J. Ultrasound-guided umbilical catheter insertion in neonates. J Perinatol 31, 344–349 (2011). https://doi.org/10.1038/jp.2010.128

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