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Am J Perinatol
DOI: 10.1055/a-2182-4221
Original Article

Novel Umbilical Catheter Securement and Protection Device for Umbilical Line Securement during Laparotomy

Fereshteh Salimi-Jazi
1   Division of Pediatric Surgery, Department of Surgery, Stanford University, California
,
Lauren Wood
1   Division of Pediatric Surgery, Department of Surgery, Stanford University, California
,
Talha Rafeeqi
1   Division of Pediatric Surgery, Department of Surgery, Stanford University, California
,
Nicole Yamada
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, California
,
Janene Fuerch
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, California
,
James Wall
1   Division of Pediatric Surgery, Department of Surgery, Stanford University, California
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Abstract

Objective Umbilical catheter malposition rate is high. We compared a Novel Umbilical Securement Device (NUSD) to standard methodologies for neonatal invasive care unit patients undergoing laparotomy.

Study Design Retrospective study was performed on infants undergoing laparotomy from April 2019 to January 2023. Two neonatologists compared position of umbilical arterial catheter/umbilical venous catheter (UVC) on perioperative chest X-ray (CXRs) in patients with or without NUSD.

Results Eighteen patients underwent laparotomy, of which 8 patients had NUSD (9 lines) and 10 patients did not (14 lines). In NUSD group, mean gestational age was 37 ± 4 weeks and mean birth weight was 2.3 ± 0.9 kg compared with 31 ± 8 weeks and 2.1 ± 1.4 kg in non-NUSD group, respectively. The mean age at surgery was 5 ± 7 and 5 ± 3 days, respectively. No malposition was seen in NUSD group, while 57% of UVCs (28% of lines) were malpositioned postoperatively in non-NUSD group (p = 0.048).

Conclusion NUSD is an umbilical catheter securement device with low malposition rate, specifically during perioperative period with heightened risk for dislodgement.

Key Points

  • Umbilical catheters provide reliable access for neonates but have a high rate of malpositioning.

  • NUSD is an umbilical catheter securement device with low malposition rate.

  • NUSD can be kept in place during laparotomy and can decrease the risk of malpositioning.

Keywords

umbilical catheter malpositioning - umbilical catheter securement device - laparotomy in NICU patients - neonate laparotomy


Publication History

Received: 26 July 2023

Accepted: 25 September 2023

Accepted Manuscript online:
27 September 2023

Article published online:
16 November 2023

© 2023. Thieme. All rights reserved.

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  • References

  • 1 Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A. Risk factors for umbilical vascular catheter-related adverse events: a scoping review. Aust Crit Care 2022; 35 (01) 89-101
    CrossrefPubMedGoogle Scholar
  • 2 Furdon SA, Horgan MJ, Bradshaw WT, Clark DA. Nurses' guide to early detection of umbilical arterial catheter complications in infants. Adv Neonatal Care 2006; 6 (05) 242-256 , quiz 257–260
    CrossrefPubMedGoogle Scholar
  • 3 Rubortone SA, Costa S, Perri A, D'Andrea V, Vento G, Barone G. Real-time ultrasound for tip location of umbilical venous catheter in neonates: a pre/post intervention study. Ital J Pediatr 2021; 47 (01) 68
    CrossrefPubMedGoogle Scholar
  • 4 Hoellering A, Tshamala D, Davies MW. Study of movement of umbilical venous catheters over time. J Paediatr Child Health 2018; 54 (12) 1329-1335
    CrossrefPubMedGoogle Scholar
  • 5 Soonsawad S, Kieran EA, Ting JY, AlonsoPrieto E, Panczuk JK. Factors associated with umbilical venous catheter malposition in newborns: a tertiary center experience. Am J Perinatol 2021; 39 (16) 1805-1811
    PubMedGoogle Scholar
  • 6 Dubbink-Verheij GH, Visser R, Tan RNGB, Roest AAW, Lopriore E, Te Pas AB. Inadvertent migration of umbilical venous catheters often leads to malposition. Neonatology 2019; 115 (03) 205-210
    CrossrefPubMedGoogle Scholar
  • 7 Franta J, Harabor A, Soraisham AS. Ultrasound assessment of umbilical venous catheter migration in preterm infants: a prospective study. Arch Dis Child Fetal Neonatal Ed 2017; 102 (03) F251-F255
    CrossrefPubMedGoogle Scholar
  • 8 Plooij-Lusthusz AM, van Vreeswijk N, van Stuijvenberg M, Bos AF, Kooi EMW. Migration of umbilical venous catheters. Am J Perinatol 2019; 36 (13) 1377-1381
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Wood LSY, Fuerch JH, Dambkowski CL. et al. Novel neonatal umbilical catheter protection and stabilization device in in vitro model of catheterized human umbilical cords: effect of material and venting on bacterial colonization. Am J Perinatol 2021; 38 (06) 560-566
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Shahid S, Dutta S, Symington A, Shivananda S. McMaster University NICU. Standardizing umbilical catheter usage in preterm infants. Pediatrics 2014; 133 (06) e1742-e1752
    CrossrefPubMedGoogle Scholar
  • 11 Gordon A, Greenhalgh M, McGuire W. Early planned removal of umbilical venous catheters to prevent infection in newborn infants. Cochrane Database Syst Rev 2017; 10 (10) CD012142
    CrossrefPubMedGoogle Scholar
  • 12 Young A, Harrison K, Sellwood MW. How to use… Imaging for umbilical venous catheter placement. Arch Dis Child Educ Pract Ed 2019; 104 (02) 88-96
    CrossrefPubMedGoogle Scholar
  • 13 Vachharajani AJ, Vachharajani NA, Morris H. et al. Reducing peripherally inserted central catheters in the neonatal intensive care unit. J Perinatol 2017; 37 (04) 409-413
    CrossrefPubMedGoogle Scholar
  • 14 Gupta R, Drendel AL, Hoffmann RG, Quijano CV, Uhing MR. Migration of central venous catheters in neonates: a radiographic assessment. Am J Perinatol 2016; 33 (06) 600-604
    Article in Thieme ConnectPubMedGoogle Scholar