An alternative method to temporarily secure umbilical catheter(s) in the Neonatal Intensive Care Unit at the Royal Women’s Hospital, in routine care of newborns requiring central vascular access
- Research Opportunity
- Number of Honour Places Available
- Obstetrics and Gynaecology
- Royal Children’s Hospital/Murdoch Childrens Research Institute
|Dr, MD, PhD Marta Thiofirstname.lastname@example.org||+61450886176|
|Professor Peter G Davisemail@example.com||+61417039736|
Umbilical catheters are often used for the stabilization and ongoing management of a critically ill neonate in NICU. Current routine practice is to apply a suture at the base of the umbilical cord with some more ties along the catheter, which is then covered with adhesive tape (A). This method provides secure catheter placement but often the process is time-consuming. This may contribute to delays in commencement of intravascular therapy during the “Golden Hour” after birth, and can result in adverse events such as hypoglycaemia and hypothermia.
Recently, our research group conducted a benchtop study to test the use of a plastic clamp as an alternative method to secure umbilical venous catheters (B). Our results showed that the cord clamp was simple to use, significantly reduced the time to secure umbilical catheters compared with current suture technique (6 s versus 49 s, p<0.001), was more effective in preventing catheter dislodgement (0% versus 17.5%, p = 0.006), and did not occlude the catheter compared to the suturing when infusing small volumes (5 mL, p=0.102). However, more occlusion events occurred when infusing large volumes (30mL) through the clamp versus the suture (20% versus 0%, p=0.003).
In this prospective interventional cohort study we will test the safety and efficacy of temporarily securing umbilical catheters with a plastic clamp in 50 newborn infants requiring umbilical catheters in NICU, until the Xray confirms their adequate position. If this method is effective, it will be implemented as standard of care for the cannulation of umbilical vessels in NICU. If the number of obstructions remains low and easily reversible, this technique may also become standard practice to secure umbilical catheters in an emergency scenario, i.e. during newborn resuscitation.
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Research NodeRoyal Children’s Hospital/Murdoch Childrens Research Institute
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