PROSPECTIVE OBSERVATIONAL STUDY ON COMPARISON OF TWO/THREE FORMULAE FOR CORRECT POSITION OF TIP OF UMBILICAL VENOUS CATHETER AT THE JUNCTION OF INFERIOR VENA CAVA AND RIGHT ATRIUM IN INDIAN NEONATES

Abstract

Umbilical vein catheterization (UVC) offers immediate vascular access for preterm or critically ill newborns requiring fluid resuscitation, intravenous therapy, or parenteral nutrition. This procedure is both quick and minimally painful. A prospective observational study was conducted o evaluate the accuracy of three UVC insertion techniques: Dunn, Shukla-Ferrara, and the Revised Shukla-Ferrara method. A total of 300 neonates were enrolled, with equal distribution across the three methods. The Revised Shukla-Ferrara method achieved the highest rate of correct catheter placement (70%), followed by the Shukla-Ferrara method (45%) and Dunn’s method (38%).Among the complications, Dunn’s method was associated with the highest number of adverse events, including 18 cases of tachycardia and 16 of bradycardia, although it also showed relatively better outcomes in managing bradycardia (10 appropriate responses) and positive tip cultures (6 cases) compared to the other two techniques. The Shukla-Ferrara method demonstrated a more balanced outcome for tachycardia, with 9 successful cases, but showed a higher rate of tip culture positivity (5 cases). The Revised Shukla-Ferrara method had the fewest overall complications, although it showed fewer favorable results for tachycardia (3 cases).The study identified statistically significant differences among the three techniques in terms of catheter placement accuracy. Ultimately, the Revised Shukla-Ferrara method proved to be the most effective for proper UVC positioning, emphasizing the critical role of technique selection in optimizing outcomes for neonatal catheterization.