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  • Review Article
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Point-of-care ultrasound use in umbilical line placement: a review

Abstract

Point-of-care ultrasound (POCUS) has become a novel tool for assessing umbilical catheter tip location in the neonate. This review analyzes the current evidence on the efficacy and utility of POCUS for identifying umbilical catheter positioning. Medline, EMBASE, and Cochrane searches were performed until October 2018. Eight studies were identified comparing POCUS to x-ray in assessing umbilical catheter tip location in the last 10 years. POCUS was shown to be feasible and appears to be a superior imagining modality to x-rays in assessing umbilical line tip location. POCUS is more accurate in determining umbilical catheter positioning, allows for more rapid line umbilical catheter placement, and reduces the time to treatment as well as radiation exposure to the neonate when compared with x-ray. The available studies support further education in training neonatal providers to become proficient in POCUS for assessing umbilical lines.

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References

  1. Franta J, Harabor A, Soraisham AS. Ultrasound assessment of umbilical venous catheter migration in preterm infants: a prospective study. Arch Dis Child Fetal Neonatal Ed. 2017;102:F251.

    Article  Google Scholar 

  2. Hagerott HE, Kulkarni S, Restrepo R, Reeves-Garcia J. Clinical-radiologic features and treatment of hepatic lesions caused by inadvertent infusion of parenteral nutrition in liver parenchyma due to malposition of umbilical vein catheters. Pediatr Radio. 2014;44:810–5.

    Article  Google Scholar 

  3. Menon G. Neonatal long lines. Arch Dis Child Fetal Neonatal Ed. 2003;88:F260.

    Article  CAS  Google Scholar 

  4. Mutlu M, Aslan Y, Kul S, Yilmaz G. Umbilical venous catheter complications in newborns: a 6-year single-center experience. J Matern Fetal Neonatal Med. 2016;29:2817–22.

    PubMed  Google Scholar 

  5. Dunn PM. Localization of the umbilical catheter by post-mortem measurement. Arch Dis Child. 1966;41:69–75.

    Article  CAS  Google Scholar 

  6. Shukla H, Ferrara A. Rapid estimation of insertional length of umbilical catheters in newborns. Am J Dis Child. 1986;140:786–8.

    CAS  PubMed  Google Scholar 

  7. Guimarães AF, Souza AA, Bouzada MC, Meira ZM. Accuracy of chest radiography for positioning of the umbilical venous catheter. J Pediatr (Rio J). 2017;93:172–8.

    Article  Google Scholar 

  8. Fleming SE, Kim JH. Ultrasound-guided umbilical catheter insertion in neonates. J Perinatol. 2011;31:344.

    Article  CAS  Google Scholar 

  9. Puch-Kapst K, Juran R, Stoever B, Wauer RR. Radiation exposure in 212 very low and extremely low birth weight infants. Pediatrics. 2009;124:1556–64.

    Article  Google Scholar 

  10. George L, Waldman JD, Cohen ML, Segall ML, Kirkpatrick SE, Turner SW, et al. Umbilical vascular catheters: Localization by two-dimensional echocardio/aortography. Pediatr Cardiol. 1982;2:237–43.

    Article  CAS  Google Scholar 

  11. Madar RJ, Deshpande SA. Reappraisal of ultrasound imaging of neonatal intravascular catheters. Arch Dis Child Fetal Neonatal Ed. 1996;75:F62.

    Article  CAS  Google Scholar 

  12. Saul D, Ajayi S, Schutzman DL, Horrow MM. Sonography for complete evaluation of neonatal intensive care unit central support devices. J Ultrasound Med. 2016;35:1465–73.

    Article  Google Scholar 

  13. Simanovsky N, Ofek-Shlomai N, Rozovsky K, Ergaz-Shaltiel Z, Hiller N, Bar-Oz B. Umbilical venous catheter position: evaluation by ultrasound. Eur Radio. 2011;21:1882–6.

    Article  Google Scholar 

  14. Michel F, Brevaut-Malaty V, Pasquali R, Thomachot L, Vialet R, Hassid S, et al. Comparison of ultrasound and X-ray in determining the position of umbilical venous catheters. Resuscitation. 2012;83:705–9.

    Article  Google Scholar 

  15. Hoellering AB, Koorts PJ, Cartwright DW, Davies MW. Determination of umbilical venous catheter tip position with radiograph. Pediatr Crit Care Med. 2014;15:56–61.

    Article  Google Scholar 

  16. Harabor A, Soraisham A. Rates of intracardiac umbilical venous catheter placement in neonates. J Ultrasound Med. 2014;33:1557–61.

    Article  Google Scholar 

  17. Nguyen J. Ultrasonography for central catheter placement in the neonatal intensive care unit-a review of utility and practicality. Am J Perinatol. 2016;33:525–30.

    Article  Google Scholar 

  18. Castrodale V, Rinehart S. The golden hour: improving the stabilization of the very low birth-weight infant. Adv Neonatal Care. 2014;14:9–14. quiz 5-6

    Article  Google Scholar 

  19. Scott MV, Fujii AM, Behrman RH, Dillon JE. Diagnostic ionizing radiation exposure in premature patients. J Perinatol. 2014;34:392.

    Article  CAS  Google Scholar 

  20. Donadieu J, Zeghnoun A, Roudier C, Maccia C, Pirard P, Andre C, et al. Cumulative effective doses delivered by radiographs to preterm infants in a neonatal intensive care unit. Pediatrics. 2006;117:882–8.

    Article  Google Scholar 

  21. Kluckow M, Evans N. Point of care ultrasound in the NICU—training, accreditation and ownership. Eur J Pediatr. 2016;175:289–90.

    Article  Google Scholar 

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Correspondence to Eileen Cowan.

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Meinen, R.D., Bauer, A.S., Devous, K. et al. Point-of-care ultrasound use in umbilical line placement: a review. J Perinatol 40, 560–566 (2020). https://doi.org/10.1038/s41372-019-0558-8

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  • DOI: https://doi.org/10.1038/s41372-019-0558-8

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