Abstracto

Assessment of umbilical venous catheter insertion depth using Dunn and Shukla method.

Ali Adel Shareef*, Ruaa F Mohammed, NazarAbdulkadir Kandla

Objectives: Umbilical venous catheterization is a commonly used intervention in the Neonatal Intensive Care Unit (NICU), and it is important to estimate the optimal depth of catheter insertion in order to minimize complications of catheterization. The aim of this study was to compare Dunn and Shukla's methods for predicting the length of umbilical venous catheter insertion at varying birth weight. Materials and Methods: This is a prospective comparative study conducted on newborns subjected to Umbilical Venous Catheterization (UVC) at the NICU at AL-Khansaamaternity and children’s teaching hospital, Mosul, Iraq over 12 months beginning on 1 August 2019. The catheter tip position was evaluated with thoracoabdominal AP radiographs and considered correct if the tip was visible between T9 and T10, under insertion (below T10), and over-insertion (above T9). Results: A total of 111 infants were enrolled during the study period. Fourteen infants were excluded because their UVCs tips were located laterally in the portal venous system and the remaining 97 infants were analyzed, of which 49 were allocated to Dunn’s group and 48 to Shukla’s group randomly.Dunn's method was more accurate than Shukla’s method for determining the optimal insertion length of UVCs (45% vs. 25%, P=0.04); especially in infants with birth weight <1500 g (59% vs. 11%, P=0.00296). Whereas, a significantly higher rate of highly positioned catheter tips was demonstrated in Shukla's method than in Dunn's method (73% vs. 51%, P=0.0264); and especially in infants with birth weight <1500 g (89% vs. 35%, P=0.00104). While the analysis did notshow any significant difference in the proportions of low positioned catheter tips between the two groups. Conclusion: This study showed that Dunn’s method resulted in a higher rate of ideal insertion length of UVCs than Shukla’s method. The rate of correctly positioned catheter tip was significantly high in Dunn’s method especially in infants with birth weight <1500 g. whereas, the rate of highly positioned catheter tip was significantly high in Shukla’s method particularly in infants with birth weight <1500 g.