National survey of umbilical venous catheterisation practices in the wake of two deaths

Umbilical venous catheter (UVC) insertion is a common invasive procedure. Multiple complications associated with UVCs are described,1 though their relative incidence is unknown. In 2013, 8746 UVCs were inserted in 164 English neonatal intensive care units comprising a total of 37 100 line days (NDAU, unpublished data). In 2014, two deaths related to UVC extravasation were notified to the British Association of Perinatal Medicine (BAPM) and the National Health Service (NHS) National Reporting and Learning System. Both involved parenteral nutrition (PN) infusion via low-lying UVCs, that is, catheter tips located below the position presently considered ideal (the inferior vena cava–right atrial junction, approximately T8-9 level).1 These cases prompted the present survey. We designed a web-based survey to determine current practices relating …