Supplementary Material for: COMPARISON OF ULTRASOUND-GUIDED UMBILICAL VENOUS CATHETER INSERTION WITH BLIND METHOD – A RANDOMIZED CONTROLLED TRIAL

Introduction: Ultrasonography (USG) can be used in neonates to manipulate and place the umbilical catheter in correct position. Though chest radiograph (CXR) is the gold standard, a non-invasive method like USG without radiation exposure may be an alternative bedside armamentarium to the clinician. The purpose of the study was to evaluate whether USG-guided umbilical venous catheter (UVC) insertion is superior to the conventional method for successful insertion of UVC.
Method: The neonates born between 25-42 weeks of gestation requiring parenteral fluids and admission to neonatal intensive care unit between September 2020 to November 2022, were randomized in two weight-based strata: ≤1200 and > 1200 grams. USG guided UVC insertion was done in intervention group and blind UVC insertion was done in the control group.
Results: Out of 112 enrolled neonates, 58 were in the USG guided group and 54 in the blind group. There was no significant difference in failure rate between the intervention and control groups [20% vs 29% (RR - 0.69, 95% CI-0.36-1.33)]. The sensitivity and specificity of USG in locating tip position were 97% and 46.8%, respectively. The mean procedure time in USG and blind group was 8.9 and 8.3 minutes respectively (P value-0.56).
Conclusion: USG does not reduce the failure rates during the insertion of umbilical catheters. However, being a safe, noninvasive procedure, it can be considered a rescue modality to CXR in NICUs equipped with portable USG for guiding UVC insertion.