Comparison of Bridging and Contactless Technique for Umbilical Catheter Securement in Preterm Infants: A Pilot Randomized Controlled Trial

Abstract

Objective: To compare the rate of catheter dislodgement between the bridging technique and contactless technique (CLT) for umbilical catheter securement in preterm infants. Materials and Methods: This pilot randomized controlled trial enrolled 30 preterm infants who were randomized in a 1:1 ratio into either the bridging or CLT group. The primary outcome was catheter dislodgement. Secondary outcomes included skin injury, procedural duration, and complications such as omphalitis, catheter-related bloodstream infection (CRBSI), and hypothermia. Results: A total of 15 patients were included in each group. In the CLT group, 25 catheters were placed (12 umbilical arterial catheters (UAC) and 13 umbilical venous catheters (UVC)), while 24 catheters were placed in the bridging group (10 UACs and 14 UVCs). There was no significant difference in catheter dislodgement rates (1 in 25 catheters in the CLT group vs 0 in 24 catheters in the bridging group, p = 1.00). There was no CRBSI in either group. Skin injuries were minimal, with one case in the bridging group and none in the CLT group (p = 1.00). Repositioning challenges were observed with the CLT after the umbilical stump had dried. Conclusion: The CLT method demonstrated comparable catheter stability to the bridging technique and may reduce skin injury. It is cost-effective and simple to apply. However, its effectiveness in extremely preterm infants requires further investigation.