Revised formula to determine the proper insertion length of umbilical vein catheter
Keywords:
newborn, umbilical venous catheter, umbilical venous catheter positionAbstract
Background: The placement of umbilical vein catheter (UVC) is an essential part of neonatal care in the neonatal intensive care unit (NICU) for fluid, nutrition, and medication administration. Nowadays there is no universal formula to predict the proper length of UVC. Shukla and Ferrara formula is one of the most frequently used methods, but often leads to UVC over-insertion. Malposition of UVCs can lead to complications.
Objective: To determine a new formula to calculate the umbilical catheter insertion length
Methods: This retrospective observational cohort design included sick neonates admitted to NICU at Nakornping Hospital during June 2019 - March 2020 whose umbilical vein had been catharized successfully. The mean proper position was estimated from the mean of the distance between the lower border of the 9th vertebra to the upper border of the 10th vertebra from the corresponding anterior-posterior (AP) chest radiographs with INFINIT Version 1.2.3.0 BN8 Interface 2.1.4.6 program.
Results: One hundred and thirty-five neonates were enrolled to the study with the mean gestational age (GA) of 34.39 ± 4.35 weeks. There were 44 neonates of GA less than 32 weeks and 91 neonates of GA more than or equal to 32 weeks. The means of UVC length and proper UVC length were 9.43 ± 1.53 and 7.97 ± 1.54 cm, respectively. The birth weight (BW) is significantly related to the proper UVC length (P-value <0.001). The regression test was used to generate the formula. Our study showed the relation as follows: UVC length (cm) = 1.10*BW (kg)+5.57 (R2=0.4795). In a subgroup analysis, the formulas for neonates whose GA are less than 32 weeks and GA are more than or equal to 32 weeks were 1.07*BW (kg)+5.70 (R2=0.0886) and 1.20*BW(kg)+5.25 (R2=0.4350) respectively.
Conclusion: The UVC length from the equation 1.10*BW (kg)+5.57 was not different from the proper UVC length (P-value =0.983). This new revised formula can predict the proper UVC length.
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