hello every one  ,,  

 

i wonder if there is any techniques that would increase the chances for more successful UVC insertion ?

 

we use feeding tube as UVC tube ( lack of facility ) , some drs, (especially in good sized baby)  and in order to avoid placement of the tube in the liver ,  they put the first tube and advance it slowly , but if they feel any resistance , they put another tube (now we have 2 ) , the reason behind this technique is the first one stuck at the liver and the second one has no where to go so the only remained tract is toward the heart.

 

i don't feel its right to do this , so any one has some answers  ,,,   if there is  some useful techniques to improve the chances of optimum UVC  ? and what about our technique??

Very practical issue.....

We use Vygon UVC as routinely. In case of nonavailability of non affording patient, w use NG tube, same as you do.

Practically it is encountered vry often that UVC is not advancing or have resistance. In that case we follow 2 techniques.

1. If we are using Vygon UVC and not advancing, we sometimes switch over to NG tube. Bcs Conventional UVC, including Vygon has opening at tip, while NG tube has blunt tip with side openings. This BLUNT TIP of NG tubes helps to pass through the resistence in LIVER.

2. IF we still have issues with advancing the NG tube, while inserting NG slowly with one hand, we give slight pressure on liver with another hand. The pressure is being given on the skin overlying Liver in downward direction while slowly advancing the NG as UVC. Most of the times, this proves helpful, even with Vygon UVC. 

Another technique is slowly advancing UVC in cork screw manner, if resistence is felt. But somehow, I have not fount this working.

Pressure over Liver, many times has solved problem for us.

Hope this proves useful to you.

Do let me know for anything else, at manan179@yahoo.com

Edited August 14, 20159 yr by Manan179

There's one article with a title of " Increased success rate in umbilical venous Catheter positioning by posterior liver mobilization" published in 2010 in Archives de Pediatrie in french language.The abstract was in English & french( but the whole article was in french).

The authors(in the abstract) described a 50% higher incidence of successful UVC position with postero-lateral mobilization of the liver.

Personally; I didn't try that described  technique ,meanwhile, I tried many times to insert a 2nd UVC (if the first one is hepatic in position) but it has never worked out.

I'm currently testing a corrective technique for improperly positioned UVC but not yet ready to declare further details about it.

I think the literature about umbilical venous catheterization is lacking about corrective techniques for an improperly positioned UVC and this would be a good field of research.