Author Of 1 Presentation
MONITORING OF UMBILICAL VENOUS CATHETER TIP POSITION OVER TIME USING PLAIN FILM ANTEROPOSTERIOR X-RAY IN EXTREME PRETERM NEONATES
Abstract
Background
Umbilical venous catheters (UVCs) are commonly used in NICU. Malpositioned UVCs (those not sited in the thoracic inferior vena cava) are associated with risk of serious and life-threatening complications.
Objectives
To monitor changes in UVC tip position over dwell time using plain film anteroposterior X-ray in extreme preterm neonates.
Methods
A retrospective study of all (75) extreme preterm neonates (23+0 - 27+6 weeks) with UVCs sited who were cared for in a tertiary NICU in Bristol, UK between January 2017 and June 2018. Sixty cases met inclusion criteria. Tip position was assessed on x-ray after any initial adjustment of position and on all subsequent x-rays. Good position was defined as between the 7th and 9th thoracic vertebrae.
Results
Fifty-seven per cent (34) of UVCs were in a good position after initial adjustment. Mean UVC dwell time was 5.4 (±2.3) days. Mean migration of all well-positioned UVCs was 2.1 (±1.2) vertebral levels during dwell time (after initial adjustment) and 32% (11) remained in a good position throughout dwell time. Sixty seven per cent (23) became malpositioned, all migrating outwards. Thirty eight per cent (13) moved outwards by 3 or more vertebral levels and 44% (15) to the 11th thoracic vertebra or lower.
Conclusion
This study shows that most well sited UVCs migrated outwards, many sufficiently to risk complications. UVC position needs regular reassessment to alleviate the risks associated with malposition.