Umbilical vein catheter insertion without umbilical remnant in neonatal emergencies - A pilot study

Abstract

Background: Investigate the feasibility of umbilical vein catheter insertion without umbilical remnants. Methods:A total of 72 infants who needed umbilical vein catheter insertion was included. The study was conducted from October 1, 2020, to December 10, 2022, from the neonatal intensive care unit at HuiZhou Central People’s Hospital. The infants were categorized into the two groups according to whether their umbilical stumps were ligated to the end near the annulus umbilicalis using a rubber-ring or suture line. Umbilical vein catheter tip positions, medications given via umbilical vein catheter, duration from birth to insertion, duration of umbilical vein catheter indwelling time, removal for no blood aspiration, limited use, unplanned removal, and any umbilical catheter-associated complications were compared between two groups. Results:In comparisons of umbilical vein catheter tip positions, characteristics of utilization and complications revealed no statistically significant differences. The duration from birth to insertion in the group without remnants was 7.82 hours (range 4.44-14.57), while it was 11.89 hours (range 5.50-20.34) in the group with remnants. The duration of umbilical vein catheter indwelling time in the group without remnants was 6.50±3.06 days, while it was 6.10±2.76 days in the group with remnants.In the group without remnants, 12.5% (4/32) experienced abdominal distension compared with 5.0% (2/40) in the group with remnants. Gastrointestinal hemorrhage was 12.5% (4/32) versus 2.5% (1/40). Conlusions: This study indicates that it is practical to perform umbilical vein catheter insertion without umbilical remnants. It provides another way to obtain vessel access for initial stabilization. Registration number is ChiCTR2300071411. Date of registration：15/05/2023, retrospectively registered