title: Umbilical venous catheter position: evaluation by ultrasound.
abstract: OBJECTIVE
  Umbilical venous catheter (UVC) insertion is frequently performed in critically ill neonates, with catheter position evaluated by an abdominal radiograph. The position of the catheter can be difficult to assess based on supine film alone. We aimed to determine whether ultrasound enables precise evaluation of the catheter tip position.
  
  
  METHODS
  We prospectively evaluated UVC position in 75 neonates by ultrasound and supine abdominal radiograph. Distance from the catheter tip to the diaphragm was measured for both modalities. Anatomical location of the catheter was recorded for both studies. The Student's t-test was used to compare the means of the differences in catheter position on radiograph and ultrasound.
  
  
  RESULTS
  In 46 patients there was no difference in the distance between the catheter tip and the diaphragm on ultrasound and radiograph. In 29 babies there was a difference of 1-to-7 mm. Ultrasound identified malposition of the catheter in three cases in which the position of the catheter on the plain film was deemed acceptable.
  
  
  CONCLUSIONS
  Our study suggests that ultrasound is reliable and may replace plain radiograph for the identification of the UVC position, preventing complications from malposition, and reducing exposure to ionizing radiation.
authors.affiliation: Department of Medical Imaging, Hadassah Hebrew University Medical Center, POB 24035, Jerusalem 91240, Israel. natalias@hadassah.org.il
authors.forename: Natalia
authors.initials: N
authors.lastname: Simanovsky
authors.forename: Noa
authors.initials: N
authors.lastname: Ofek-Shlomai
authors.forename: Katya
authors.initials: K
authors.lastname: Rozovsky
authors.forename: Zivanit
authors.initials: Z
authors.lastname: Ergaz-Shaltiel
authors.forename: Nurith
authors.initials: N
authors.lastname: Hiller
authors.forename: Benjamin
authors.initials: B
authors.lastname: Bar-Oz
mesh_terms: D000818:Animals; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D057785:Catheters; D002417:Cattle; D004868:Equipment Failure; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*; D014471:Umbilical Veins / Q000000981:diagnostic imaging*