Abstract:
Introduction: In neonatal units, umbilical vessel catheterization is the preferred method to gain vascular access in the initial management of the newborn because it is quick and easy. The failure rate ranges from to 50%, as the catheter can be found in the portal system in up to 40% of cases, leading to complications. This failure rate warrants the investigation of different methods to reduce the frequency of catheter malposition. We describe different techniques to improve the success rate in umbilical vein catheterization, such as the double catheter technique, positioning the newborn in right lateral decubitus for insertion, liver compression, and ultrasound-guided catheter insertion. The primary objective of the study was to assess the impact of new techniques on the success rate of central umbilical venous catheterization.
Material and methods: Pre- and post-intervention quasi-experimental study in a level B NICU conducted in January-June 2022 (pre-intervention) and July-December 2022 (post-intervention).
Results: Prior to the introduction of these new catheterization techniques, the failure rate of blind umbilical catheter insertion was 52%. Since the introduction of these measures, the overall failure rate has decreased to 27%.
Conclusions: After the introduction of the new catheterization and recanalization methods, our success rate in umbilical vein catheterization has increased, and we believe it is necessary to implement them in units with similar failure rates to ours.
Reference:Torres Del Pino M, Gómez Santos E, Domínguez Quintero ML, Mendoza Murillo B, Millán Zamorano JA, Toledo Muñoz-Cobo G, Mora Navarrocor D. Steps to improve umbilical vein catheterization in neonatal care. An Pediatr (Engl Ed). 2023 Aug 30:S2341-2879(23)00188-6. doi: 10.1016/j.anpede.2023.08.006. Epub ahead of print. PMID: 37658020.