Reducing Umbilical Catheter Migration Rates by Using a Novel Securement Device

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2024 Mar 24

PMID 38521880

Authors

Juliana R Perl

Tanya Crabtree-Beach

Amy Olyaei

Madeline Hedges

Brian K Jordan

Brian Scottoline

Affiliations

Soon will be listed here.

Abstract

Objective: This study evaluates the effectiveness of a novel device, LifeBubble, in reducing umbilical cord catheter (UC) migration and associated complications in neonates.

Study Design: A retrospective review was performed at Oregon Health & Science University's NICU (2019-2021) to compare standard adhesive securement with LifeBubble. The primary outcomes were UC migration, discontinuation due to malposition, and CLABSI incidence. Differences between groups were statistically analyzed and logistic regression used to adjust for potential confounders.

Results: Among 118 neonates (57 LifeBubble, 61 adhesive), LifeBubble significantly reduced migration of any UC > 1 vertebral body (12.3% vs. 55.7%), including UVC migration (5.3% vs. 39.3%) and UAC migration (7.0% vs 23.0%), as well as UVC discontinuation due to malposition (5.6% vs 37.7%). The number needed to treat (NNT) to prevent one instance of UVC discontinuation is 4.

Conclusion: LifeBubble effectively reduces UC migration and premature discontinuation, indicating its potential to enhance neonatal care and safety.

References

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. 2021; 35(1):89-101. DOI: 10.1016/j.aucc.2021.02.010. View

OMara M, Reed N, Palmieri T, Greenhalgh D . Central venous catheter infections in burn patients with scheduled catheter exchange and replacement. J Surg Res. 2007; 142(2):341-50. DOI: 10.1016/j.jss.2007.03.063. View

Anderson J, Leonard D, Braner D, Lai S, Tegtmeyer K . Videos in clinical medicine. Umbilical vascular catheterization. N Engl J Med. 2008; 359(15):e18. DOI: 10.1056/NEJMvcm0800666. View

Hoellering A, Tshamala D, Davies M . Study of movement of umbilical venous catheters over time. J Paediatr Child Health. 2018; 54(12):1329-1335. DOI: 10.1111/jpc.14073. View

Greenberg M, Movahed H, Peterson B, Bejar R . Placement of umbilical venous catheters with use of bedside real-time ultrasonography. J Pediatr. 1995; 126(4):633-5. DOI: 10.1016/s0022-3476(95)70366-7. View

Fleming S, Kim J . Ultrasound-guided umbilical catheter insertion in neonates. J Perinatol. 2011; 31(5):344-9. DOI: 10.1038/jp.2010.128. View

Tsui B, Richards G, Van Aerde J . Umbilical vein catheterization under electrocardiogram guidance. Paediatr Anaesth. 2005; 15(4):297-300. DOI: 10.1111/j.1460-9592.2005.01433.x. View

DAndrea V, Prontera G, Pinna G, Cota F, Fattore S, Costa S . Securement of Umbilical Venous Catheter Using Cyanoacrylate Glue: A Randomized Controlled Trial. J Pediatr. 2023; 260:113517. DOI: 10.1016/j.jpeds.2023.113517. View

Bersani I, Piersigilli F, Iacona G, Savarese I, Campi F, Dotta A . Incidence of umbilical vein catheter-associated thrombosis of the portal system: A systematic review and meta-analysis. World J Hepatol. 2021; 13(11):1802-1815. PMC: 8637679. DOI: 10.4254/wjh.v13.i11.1802. View

Gibson K, Sharp R, Ullman A, Morris S, Kleidon T, Esterman A . Adverse events associated with umbilical catheters: a systematic review and meta-analysis. J Perinatol. 2021; 41(10):2505-2512. DOI: 10.1038/s41372-021-01147-x. View

Fletcher M, Brown D, Landers S, Seguin J . Umbilical arterial catheter use: report of an audit conducted by the Study Group for Complications of Perinatal Care. Am J Perinatol. 1994; 11(2):94-9. DOI: 10.1055/s-2007-994564. View

Sanderson E, Yeo K, Wang A, Callander I, Bajuk B, Bolisetty S . Dwell time and risk of central-line-associated bloodstream infection in neonates. J Hosp Infect. 2017; 97(3):267-274. DOI: 10.1016/j.jhin.2017.06.023. View

Boo N, Wong N, Zulkifli S, Lye M . Risk factors associated with umbilical vascular catheter-associated thrombosis in newborn infants. J Paediatr Child Health. 1999; 35(5):460-5. DOI: 10.1046/j.1440-1754.1999.355392.x. View

10.

Vachharajani A, Vachharajani N, Morris H, Niesen A, Elward A, Linck D . Reducing peripherally inserted central catheters in the neonatal intensive care unit. J Perinatol. 2017; 37(4):409-413. DOI: 10.1038/jp.2016.243. View

11.

Levit O, Shabanova V, Bizzarro M . Umbilical catheter-associated complications in a level IV neonatal intensive care unit. J Perinatol. 2020; 40(4):573-580. DOI: 10.1038/s41372-019-0579-3. View

12.

Hollingsworth C, Clarke P, Sharma A, Upton M . National survey of umbilical venous catheterisation practices in the wake of two deaths. Arch Dis Child Fetal Neonatal Ed. 2015; 100(4):F371-2. DOI: 10.1136/archdischild-2015-308327. View

13.

Taylor J, McDonald S, Tan K . A survey of central venous catheter practices in Australian and New Zealand tertiary neonatal units. Aust Crit Care. 2013; 27(1):36-42. DOI: 10.1016/j.aucc.2013.11.002. View

14.

DAndrea V, Prontera G, Rubortone S, Pezza L, Pinna G, Barone G . Umbilical Venous Catheter Update: A Narrative Review Including Ultrasound and Training. Front Pediatr. 2022; 9:774705. PMC: 8841780. DOI: 10.3389/fped.2021.774705. View

15.

Wood L, Fuerch J, Dambkowski C, Chehab E, Torres S, Shih J . 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. 2019; 38(6):560-566. DOI: 10.1055/s-0039-1700542. View

16.

Roham M, Momeni M, Saberi M, Kheirkhah R, Jafarian A, Rahbar H . Epidemiologic analysis of central vein catheter infection in burn patients. Iran J Microbiol. 2018; 9(5):271-276. PMC: 5748445. View