The Umbilical Cord Clamp Method-Procedural Description and Safety Assessment of a Novel Method of Umbilical Catheter Fixation After Side Entry Insertion.

Background: Umbilical venous catheter (UVC) placement is common in neonates but carries risks of migration and infection. This study evaluates safety of a novel fixation technique using the umbilical cord clamp after a side-entry insertion. Methods: A retrospective analysis of 264 neonates was conducted at a tertiary center in order to assess safety of the novel UVC fixation method. The new technique involved side-entry catheter insertion without severing the cord, secured to the clamp with a sterile patch. Catheter tip position was confirmed and monitored every 24 h via ultrasound. Results: Catheter migration occurred in 18.9% of cases, mostly inward into the right atrium which was managed by repositioning. Migration into the ductus venosus requiring removal occurred in 0.7% of cases and unscheduled removal due to stump detachment in 1.5%. No central line-associated bloodstream infections (CLABSIs) were observed. Conclusions: The umbilical cord clamp method is a safe, single-operator alternative for UVC fixation. This technique had a low rate of catheter migration, did not increase the risk of infection, and was cost-effective and simple.