A RANDOMISED CONTROL TRIAL TO ESTIMATE THE UMBILICAL VENOUS CATHETER INSERTION DEPTH IN NEWBORNS USING BIRTH WEIGHT VERSUS SHOULDER UMBILICAL LENGTH

Accurate placement of umbilical venous catheter in neonates is crucial to ensure effective delivery of fluids, medications and parenteral nutrition.  The optimal UVC tip position is at the inferior vena cava- right atrial junction. However predicting the appropriate insertion length remains challenging and different methods are in clinical use. 2 commonly practiced techniques are birth weight based formula ( Shukla and Ferrara formula) and shoulder umbilical length measurement (Dunns method). Both methods are widely used but have variable accuracy. This randomised control Trial aims to compare the accuracy of these 2 methods for estimating UVC insertion depth. Eligible neonates requiring UVC will be randomised in a 1:1 ratio to either birth weight based method or shoulder umbilical length method. In both group, calculated insertion length will be used during catherization and the tip position will be confirmed by Chest X ray. The primary outcome will be the proportion of neonates with catheter tip correctly positioned at the inferior vena cava - right atrial junction . Secondary outcomes include malpositions, catheter related complications, dwell time. This study will provide evidence regarding relative accuracy and safety of 2 commonly used methods for UVC insertion length estimation, with potential to inform Neonatal Intensive care practice and improve patient outcomes.