Placement of umbilical venous catheters with use of bedside real-time ultrasonography☆,☆☆,★
Section snippets
METHODS
Seventy-nine infants (median birth weight, 1600 gm; range, 480 to 4200 gm) admitted to the infant special care unit at the University of California-San Diego Medical Center who required UVC insertion for clinical care were enrolled in the study between June 1992 and December 1993. The protocol was approved by the institutional review board, and parental written consent was obtained. Heparin-bonded polyurethane catheters (5F and 3.5F) were inserted by the clinical team to a distance determined
RESULTS
We compared 95 radiographs and ultrasound studies for 79 patients. In all patients the catheters were easily seen (Fig. 1). Initial placement of 60 UVCs was done with radiographs and ultrasonography was used in placement of the remaining 35 UVCs. Of the 60 catheters placed with radiographic guidance, 34 (56%) were repositioned because of unsatisfactory location, requiring more than one radiograph.
Figure 2 shows the relationship between the anatomic location of the catheters visualized by
DISCUSSION
Our data indicate that real-time ultrasonography at the bedside can be used to determine the position of UVCs in critically ill term and preterm infants. Although the catheters were visualized in all patients, fluid injection was helpful to image the exact position of the tip. Real time ultrasonography was more effective than radiography because the location of the UVC in the body could be determined, and the catheters could be positioned at the RA-IVC junction during the initial insertion
References (5)
- et al.
Umbilical venous catheterization in the newborn: identification of correct positioning
Radiology
(1970) - et al.
Proper localization of umbilical arterial catheters and venous catheters by lateral roentgenogram
Pediatrics
(1969)
Cited by (0)
- ☆
From the Departments of Neonatology and Pediatrics, University of California-San Diego, San Diego, California
- ☆☆
Reprint requests: Mark Greenberg, MD, 2220 River Run Dr., No. 113, San Diego, CA 92108.
- ★
0022-3476/95/$3.00 + 0 9/24/61032