Incidence and related factors of umbilical venous catheter tip migration / 中华围产医学杂志

ABSTRACT

Objective:To analyze the incidence and the related factors of umbilical vein catheter (UVC) tip migration within 7 d after umbilical vein catheterization.Methods:This prospective study involved neonates who were successfully indwelled with UVCs in the Department of Neonatology of Gansu Provincial Women and Child-care Hospital from June 2020 to December 2021. The position of the UVC tip, length of umbilical stump, body weight, and abdominal circumference were recorded after the UVCs were inserted successfully, and the changes in these four data at 2, 24, 48, 72 h, and 7 d after catheterization were analyzed and compared. All the subjects were divided into the non-migrate group, inward migration group, and outward migration group. Chi-square test, Mann-Whitney U test, or Kruskal Wallis H test were used for statistical analysis. Results:A total of 157 newborns were enrolled, with 51 cases in the inward migration group, 62 cases in the outward migration group, and 44 cases in the non-migrate group. There were no significant differences among the three groups regarding gestational age, birth weight, gender, born through cesarean section, age at the time of catheterization, use of sedation, and feeding modes (all P>0.05). The migration rates of UVCs tip at 2, 24, 48, 72 h, and 7 d after catheterization were 0, 27.4% (43/157), 27.2% (31/114), 25.3% (21/83), and 29.0% (18/62), respectively. The cumulative migration rates at 24, 48, 72 h, and 7 d were 27.4% (43/157), 47.1% (74/157), 60.1% (95/157), and 72.0% (113/157), respectively. Compared with the non-migrate group, the inward migration group had a shorter umbilical cord stump at 24 and 48 h [0.5 cm (0.4-0.5 cm) vs 0.6 cm (0.5-0.8 cm); 0.4 cm (0.3-0.5 cm) vs 0.5 cm (0.5-0.6 cm), Z=－5.55 and －3.69, both P<0.05], less abdominal circumference increment at 48 and 72 h [0.6 cm (0.5-1.0 cm) vs 0.9 cm (0.7-1.2 cm); 0.6 cm (0.3-0.9 cm) vs 0.9 cm (0.7- 1.3 cm), Z=－2.03 and －2.09, both P<0.05)], and more weight loss percentage [－4.7% (－6.0%-－3.6%) vs －3.1% (－3.7%-－2.2%); －6.0% (－7.5%-－5.0%) vs －3.9% (－5.1%-－2.4%), Z=－3.75 and －2.96, both P<0.05]. The abdominal circumference increased more in the outward migration group at 24, 48, 72 h, and 7 d than those in the non-migrate group [1.6 cm (0.9-1.9 cm) vs 0.7 cm (0.5-0.9 cm); 1.5 cm (1.2-1.8 cm) vs 0.9 cm (0.7-1.2 cm); 1.7 cm (1.3-1.9 cm) vs 0.9 cm (0.7-1.3 cm); 1.6 cm (1.1-1.9 cm) vs 0.9 cm (0.6-1.3 cm), Z=－4.82, －4.79, －3.74, and －3.09, all P<0.05]. Conclusion:The incidence of UVC tip migration is high, which could be affected by dryness and retraction of the umbilical cord stump and the change in neonatal abdominal circumference and body weight.