Abstract
In critically ill neonates, umbilical arterial (UAC) and umbilical venous (UVC) catheters are frequently necessary. Catheter position is usually verified by roentgenography (R) which generates ionizing radiation and requires deleterious patient manipulation. We employed 2-dimensional echocardiography (2-DE) to localize UAC and UVC catheters in 55 neonates (birth weights .65 - 5.3 kg) and compared the findings to R. Position of the UAC was determined directing the beam posteromedially towards the spine from the left cardiac border visualizing the thoracic and abdominal descending aorta in the long axis, localizing the UAC tip in 1 of 6 aortic-subdivided areas. UVC's (N=15) were localized from the subcostal view in relation to internal cardiac chambers and verified with contrast 2-DE. Position of UAC by 2-DE compared well (N=50,r=.90) with R. In localizing UVC's, R was indeterminate and erroneous in 9/15 patients; 2-DE was correct in each case.
In neonates requiring indwelling umbilical vascular catheters, localization of the catheter tip should be done by 2-DE rather than R since 2-DE: 1) is accurate, rapid and delivers no ionizing radiation, 2) relates catheter position to cardiovascular structures, 3) allows confirmation by contrast 2-DE, 4) does not require patient manipulation and 5) may allow identification of catheter-related thrombus formation.
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George, L., Waldman, J., Cohen, M. et al. 1306 LOCALIZATION OF UMBILICAL VASCULAR CATHETERS BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY. Pediatr Res 15 (Suppl 4), 661 (1981). https://doi.org/10.1203/00006450-198104001-01335
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DOI: https://doi.org/10.1203/00006450-198104001-01335
