Critical care of the newborn infant Neonatal Diseases
Conditions
Interventions
Infants will be randomly allocated to the 'WEIGHT' or 'MEASUREMENT' calculation groups.
Infants randomised to 'WEIGHT' will have the depth of insertion calculated as follows:
UVC - depth of insertio
and this measurement will be used to determine the insertion depth from a graph designed and widely used for this pupose (Dunn PM. Localization of the umbilical catheter by post-mortem measurement. Ar
Sponsors
The National Maternity Hospital (Ireland)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Infants born at any gestational age at the National Maternity Hospital (NMH) who have umbilical catheter (umbilical venous catheter [UVC] and/or umbilical arterial catheter [UAC]) insertion attempted in the Neonatal Intensive Care Unit (NICU) are eligible for enrolment 2. Infants born outside the NMH and transferred after birth will be eligible for enrollment if they have not had umbilical catheterization at the referring hospital
Exclusion criteria
Exclusion criteria: 1. Infants who have previously had a UVC or UAC inserted at a referring hospital 2. Infants with major congenital anomalies or hydrops that may alter the calculated or measured insertion length of the catheters or alter anatomy on x-ray (e.g. gastroschisis, exomphalos or congenital diaphragmatic hernia)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correct cather position determined by a Consultant Radiologist masked to treatment allocation on a chest and abdominal x-ray defined as: UVC - catheter-tip between the upper border of T9 and the lower border of T10 UAC - catheter-tip between the upper border of T6 and the lower border of T10 | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Number of umbilical line insertions attempted and successful 2. Replacement or repositioning of umbilical line post confirmation x-ray 3. Total number of x-rays performed to confirm line position 4. Complications associated with UVC positioning in the liver 5. Pericardial effusions 6. Pericardial tamponade 7. Pleural effusions 8. Air leaks 9. Cardiac arrhythmias 10. Gastrointestinal perforation 11. Necrotising enterocolitis 12. Time to 120 mL/kg/day enteral feeds 13. Cranial ultrasound abnormalities (intraventricular hemorrhage and periventricular leukomalacia) 14. Total duration of umbilical lines in situ (days) 15. Catheter-related blood stream infection related to the umbilical line 16. Duration of hospital stay (days) 17. Death before discharge and at latest follow-up | — |
Countries
Ireland
Outcome results
None listed