Measurement of the 'shoulder-umbilical' distance for insertion of umbilical catheters in newborn babies: questionnaire study.

Approximately 40 years ago, Dr. Peter Dunn introduced a simple method to determine the insertion length of umbilical catheters in neonates, by using the 'shoulder-umbilical' (S-U) length. Since then, various studies have reported a high rate of malposition of umbilical catheters. One of the possible reasons is that the method used to determine the S-U length varies among paediatric professionals. We performed a questionnaire study among 101 paediatric professionals in the Netherlands and found that the method used by the participants to measure the S-U length was highly inconsistent. Placement of an umbilical venous catheter in a too deep position may lead to potentially life-threatening complications. Therefore, uniformity in measurement is paramount for clinical and teaching purposes. Paediatric professionals using Dunn's definition to place umbilical catheters should adhere more strictly to the original description of the measurement of the S-U length.