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Optimal line and tube placement in very preterm neonates: an audit of practice
Finn, Daragh; Kinoshita, Hannah; Livingstone, Vicki; Dempsey, Eugene M.
Background: Placement of endotracheal tubes (ETTs) and umbilical catheters (UCs) is essential in very preterm infant care. The aim of this study was to assess the effect of an educational initiative to optimize correct placement of ETTs and UCs in very preterm infants. Methods: A preā€“post study design, evaluating optimal radiological position of ETTs and UCs in the first 72 h of life in infants <32 weeks gestational age (GA) was performed. Baseline data was obtained from a preceding 34-month period. The study intervention consisted of information from the pre-intervention audit, surface anatomy images of the newborn for optimal UC positioning, and weight-based calculations to estimate insertion depths for endotracheal intubation. A prospective evaluation of radiological placement of ETTs and UCs was then conducted over a 12-month period. Results: During the study period, 211 infants had at least one of the three procedures performed. One hundred and fifty-seven infants were included in the pre-education group, and 54 in the post-education group. All three procedures were performed in 50.3% (79/157) in the pre-education group, and 55.6% (30/54) in the post-education group. There was no significant difference in accurate placement following the introduction of the educational sessions; depth of ETTs (50% vs. 47%), umbilical arterial catheter (UAC) (40% vs. 43%,), and umbilical venous catheter (UVC)(14% vs. 23%). Conclusion: Despite education of staff on methods for appropriate ETT, UVC and UAC insertion length, the rate of accurate initial insertion depth remained suboptimal. Newer methods of determining optimal position need to be evaluated.
Keyword(s): Neonatal; Preterm infant; Newborn intubation; Umbilical venous catheter; Umbilical arterial catheter
Publication Date:
2017
Type: Journal article
Peer-Reviewed: Yes
Language(s): English
Institution: University College Cork
Funder(s): Science Foundation Ireland
Citation(s): Finn, D., Kinoshita, H., Livingstone, V. and Dempsey, E. (2017) 'Optimal line and tube placement in very preterm neonates: an audit of practice', Children, 4(11), 99 (8pp). doi: 10.3390/children4110099
Publisher(s): MDPI AG
File Format(s): application/pdf
Related Link(s): http://www.mdpi.com/2227-9067/4/11/99
First Indexed: 2018-02-07 06:38:52 Last Updated: 2018-02-27 06:30:30