Line Insertion through a Long Umbilical Stump: A Concept Generating Laboratory Study

Umbilical line insertion involves discomfort for preterm infants. We hypothesized that a 10- to 20-cm umbilical cord segment can be catheterized with an appropriate guide wire. This may facilitate line establishment with minimal baby discomfort. A laboratory proof-of-concept study, performed on umbilical cord segments removed from babies after delivery. In phase 1, we used a variety of techniques to determine an ideal method for long-segment umbilical vein catheterization. In phase 2, we documented the rate of successful catheter advancement using this method. We successfully advanced the catheter from the insertion point to the proximal end of the cord, an average distance of 15.7 ± 3.5 cm, in 7 out of 10 cords. It is possible to advance a catheter within the umbilical vein through a long umbilical cord segment. Clinical studies are required to evaluate whether this method may facilitate minimal handling insertion of umbilical catheters.