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  1. Martin Ward Platt, Senior Editor

https://doi.org/10.1136/archdischild-2015-310173

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    How long is a piece of string?

    Or there again, how far should an umbilical catheter be inserted to land on the sweet point in the vein or artery respectively? The system based on linear measurements which remains in common use was published by Peter Dunn 50 years ago; it was derived from post-mortem studies so it had high face validity, but was never to my knowledge subjected to a rigorous comparison with any other method. Filling this gap in knowledge, Kieran et al have done a randomised comparison of the linear measurement method against a formula based on birth weight: they found that using weight did not improve the accuracy of placing umbilical venous catheters, compared to linear measurement, but was significantly better with respect to arterial catheters. This is a really useful, practical result which could be incorporated in guidance in every neonatal service and would be a neat piece of quality improvement. See page F10

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