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A novel and accurate method for estimating umbilical arterial and venous catheter insertion length

Abstract

Objective

To develop a novel, rapid, and more accurate model for estimating umbilical arterial (UAC) and venous catheter (UVC) insertion length.

Study design

We evaluated UACs and UVCs from a retrospective cohort to determine the rate of correct initial positioning based on conventional birth weight-based equations utilized in our neonatal intensive care unit. We then derived new equations, developed the mobile application, UmbiCalc, to simplify implementation of the new equations, and validated their accuracy with prospective utilization.

Results

The conventional equations successfully predicted insertion length in 69% (364 of 524) of UACs and only 36% (194 of 544) of UVCs. Our new model was prospectively applied to 68 UAC and 80 UVC placements with successful initial positioning achieved in 90% [95% CI, 80.2–94.9] and 76% [95% CI, 65.9–84.2], respectively.

Conclusions

Our novel approach more accurately estimates UAC and UVC insertion length.

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Fig. 1: Piece-wise linear regression models for UACs (A) and UVCs (B).
Fig. 2: Flow chart of exclusion criteria for retrospective cohort.
Fig. 3: Successful initial placement using the new model compared to the Shukla equations.

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Acknowledgements

The authors thank Joshua Goss, Ph.D. and the Yale University ITS department for developing the UmbiCalc mobile app, as well as Hyung Paek, MD and Andrew Loza, MD, Ph.D. for their contribution to creating the EMR-based length estimation tool. Mobile app access: UmbiCalc is available for free on the Apple App Store and Google Play Store for iPhone and Android users, respectively.

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Contributions

CT primarily conceptualized and designed the study, collected and interpreted data, drafted the primary version of the paper, critically reviewed and revised subsequent drafts, and approved the final submitted version. VS assisted in designing the study, created the statistical models and performed all statistical analysis, critically reviewed and revised several drafts of the paper, and approved the final submitted version. SP assisted in designing the study, critically reviewed and revised several drafts of the paper, and approved the final submitted version. MB assisted in conceptualizing and designing the study, assisted with data collection, critically reviewed and revised several drafts of the paper, and approved the final submitted version.

Corresponding author

Correspondence to Christina J. Tambasco.

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The authors declare no competing interests.

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Tambasco, C.J., Shabanova, V., Peterec, S.M. et al. A novel and accurate method for estimating umbilical arterial and venous catheter insertion length. J Perinatol 41, 1633–1637 (2021). https://doi.org/10.1038/s41372-021-01121-7

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