Ultrasound guided catheter tip location in neonates
Objective: To assess Point of Care Ultrasound (POCUS) guided catheter tip location in a neonatal cohort after insertion of percutaneously inserted central catheters (PICCs) from the upper part of the body.
Study design: This was a prospective, observational study on PICC tip location. Tip site was assessed by radiological landmarks or direct ultrasound (US) visualization of the cardiovascular structures.
Results: One-hundred eighteen PICCs (28 G/1 Fr) were studied in 102 neonates (mean postmenstrual age: 31 weeks ; mean weight at positioning: 1365 grams ). Feasibility of POCUS guided tip location was 92.3% in our population. Failures were significantly associated with mechanical ventilation (aOR 5.33, 95% CI [1.13; 29.5], p=0.038). Agreement between US and radiographic methods was found in 88 out of 109 cases (80.7%). Fifteen out of 21 discordant cases led to a change in clinical management.
Conclusion: POCUS guided localization of small bore PICC is a non-invasive and effective alternative to the conventional radiogram. The latter should be recommended when US fails to locate the catheter tip.
Grasso F, Capasso A, Pacella D, Borgia F, Salomè S, Capasso L, Raimondi F. Ultrasound guided catheter tip location in neonates: a prospective cohort study. J Pediatr. 2021 Dec 28:S0022-3476(21)01266-X. doi: 10.1016/j.jpeds.2021.12.059. Epub ahead of print. PMID: 34971654.