Aims and objectives
We tried in young resident radiologist the impact of a simplified flow-chart (Fig.1) for evaluating umbilical venous catheters (UVC) placement.
Methods and materials
UVC are commonly used in the neonatal period; they can be not correctly positioned and may be associated with significant complications [1]
UVC can be misplaced in various vascular structuresas: the superior mesenteric vein,
splenic vein,
superior vena cava,
and internal jugular vein or the left atrium through a patent foramen ovale.
If the UVC perforates an intrahepatic vascular wall,
a hepatic hematoma may result [2].
Because usually fluids are administered through the UVC malposition may arise in extravascular fluid collections.
If the UVC tip...
Results
Before the evaluation of flow-chart and anatomical findings,
the residents were able to assess properly the 53% of UVC.
Then,
we showed them the flow-chart and the circulation system; after,
we repurposed them the same radiograms and the 98% of UVC were correctly evaluated.
Conclusion
To assess the correct positioning of the UVC,
we have to consider an entrance in correspondence of the right side of L3-L4 and a tip at D8-D9.
Our flow-chart (Fig.1) is useful to understand the correct placement of UVC that were easily depicted by juniors.
References
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Neonates and umbilical venous catheters: normal appearance,
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2003 Apr;180(4):1147-53.
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Singleton EB.
Radiologic considerations of intensive care in the premature infant.
Radiology 1981;140:291–300.
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Friedman AP,
Haller JO,
Boyer B,
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Calcified portal vein thromboemboli in infants.
Radiology 1981;140:381–382.
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Thrombotic complications of central venous catheters in children.
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