Prevention of umbilical catheter dislodgement and migration in neonatal population

A 23-week corrected gestation preterm infant was admitted to the neonatal intensive care unit requiring mechanical ventilation. The neonatal team successfully inserted both umbilical venous and umbilical arterial catheters and x-ray confirmed their optimal position. On day two of life, the umbilical vein catheter was found to be dislodged out of position and the umbilical artery catheter had also apparently migrated out. The neonatal team performed another umbilical vein insertion procedure. Following this procedure, the infant developed hypothermia and an increasing oxygen requirement. This literature review will question whether any intervention could have prevented the umbilical catheter dislodgement or migration.

Dr Su Wei Ng
Paediatric Speciality Trainee Neonatal unit, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough

Dr Prakash Kannan Loganathan
Neonatal Consultant Neonatal unit, James Cook University Hospital Clinical Academic Office, Faculty of Medical Sciences, Newcastle University
pkannanloganathan@nhs.net

Ng S.W., Kannan Loganathan P. Prevention of umbilical catheter dislodgement and migration in neonatal population. Infant 2025; 21(6): 169-71.

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Keywords

neonate; umbilical catheter; dislodgement; migration; malposition

Key points

Umbilical catheter malposition is common – over 90% of lines migrate. UVC complications account for a significant share of adverse events, and national mortality data confirm preventable deaths.
Cyanoacrylate glue with suturing has the best evidence so far for preventing early UVC dislodgement.
A bundle approach – including optimal placement confirmation, structured education, improved surveillance (ideally POCUS) and consistent securement technique – is more effective than any single intervention.

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