Sonography-guided positioning of intravenous long lines in neonates.
OBJECTIVE
In neonates, proper positioning of the tip of intravenous long lines (LL) is essential in order to prevent potential life-threatening complications. The gold standard for the evaluation of LL position in neonates is the chest X-ray with or without contrast. We performed a prospective study to assess the use of transthoracic ultrasonography (US) for the positioning of LL in neonates and to compare it to plain radiography.


METHODS
Thirty-six consecutive neonates requiring percutaneous LL over a period of 3 months were included in the study. Immediately after LL insertion, the position of its tip was verified using transthoracic US, followed by plain radiography. The two techniques were compared in terms of adequate placement and length of time between insertion and radiographic evaluation of the correct position.


RESULTS
The correlation between positioning by US and plain radiography was very good (r=0.97, r(2)=0.94, p<0.0001). The time needed to verify LL placement by US was shorter by a mean 15 min compared to plain radiography.


CONCLUSIONS
US can accurately guide LL tip positioning. We believe that because of the potential gain of time it offers and its lack of ionising radiation, it to be considered as an interesting tool for the positioning of LL in neonates. Yet more accurate results could be obtained with a better-trained staff.
Brissaud
Olivier
O
Neonatal and Pediatric Intensive Care Unit, Children's Hospital, Bordeaux, France. olivier.brissaud@chu-bordeaux.fr
Harper
Luke
L
Lamireau
Delphine
D
Jouvencel
Philippe
P
Fayon
Michaël
M
D002406:Catheterization, Peripheral / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015641:Radiography, Interventional / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*; D014680:Veins / Q000000981:diagnostic imaging*