Umbilical venous catheter tip placement
Abstract:
Objective: To implement a Point-of-Care-Ultrasound (POCUS) program into a large NICU to enhance care by improving (1) umbilical venous catheter (UVC) tip identification and (2) central placement.
Study Design: A POCUS program was established with core providers who received training from external and internal experts. A prospective study (n=94) compared the accuracy of UVC identification between neonatology-performed ultrasound (NeoUS) and X-ray relative to a referent of radiology-interpreted ultrasound. Finally, an US-guided UVC insertion protocol was introduced to rescue non-central traditionally-placed catheters (n=37).
Results: Program implementation trained 6 providers for a total cost of ~$10,500 USD. NeoUS was more accurate than X-ray at identifying UVC location (81.9% vs 60.6%) with improved sensitivity and specificity (80.0 and 84.6% vs 52.5% and 66.7%, respectively). POCUS-guidance was able to rescue 89.2% of catheters that were originally non-central.
Conclusion: POCUS implementation in a large NICU is feasible, affordable, and can improve quality of care.
Reference:
Wren J, Eslambolchi A, Clark K, Najaf T. Affordable Implementation of a Point-of-Care-Ultrasound Program in a Large Tertiary NICU to Assess Umbilical Venous Catheter Tips and Aid Central Placement. Am J Perinatol. 2024 Jul 2. doi: 10.1055/a-2358-6632. Epub ahead of print. PMID: 38955218.