Comparing two formulas to estimate the correct depth of the neonatal umbilical venous catheter insertion

Abstract

Aim The rate of complications among neonates with incorrectly positioned umbilical venous catheters (UVCs) is considerably increased. This prospective study aimed to evaluate whether the use of birth weight (BW) or body surface measurements as a guide for proper depth estimation of the UVC insertion was more accurate. Patients and methods A total of 104 neonates were assigned to two groups according to procedure used for proper UVC depth insertion: shoulder–umbilicus length graphs versus BW-based formula. Radiological assessment of correct catheter tip position was determined in both groups. Results The overall success rate for UVC insertion was 96% (100/104). However, in 51% (48/94) of the neonates, the UVC was not advanced to the estimated depth. Comparing infants whose UVC was secured at the correct depth and was not in the liver between the weight and measurement method, there was no significant difference in the appropriate site radiologically, but none of catheters not secured at the estimated depth were in appropriate site radiologically in the weight group, whereas some of catheters not secured at the estimated depth were in appropriate site radiologically in the measurement group, with significant difference. However, the weight method shows more sensitivity and accuracy when compared with the measurement group (100 and 75% vs. 50 and 50%, respectively), with the same specificity at 50% each. Conclusion A correct depth of insertion was more accurately achieved and showed a higher sensitivity using the BW formulae compared with the body surface measurement method.