Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns

Objectivesthe study aims to determine whether real-time ultrasound-guided umbilical venous catheter (UVC) insertion could enhance the accuracy of the procedure and reduce the number of x-ray, thereby minimizing radiation exposure of the newborn.MethodsA pre-post study was conducted, comparing outcom...

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Main Authors: Francesca Cossovel, Francesca Galdo, Luca Ronfani, Laura Travan, Cristina Bibalo, Antonella Trappan
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1567586/full
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author Francesca Cossovel
Francesca Galdo
Luca Ronfani
Laura Travan
Cristina Bibalo
Antonella Trappan
author_facet Francesca Cossovel
Francesca Galdo
Luca Ronfani
Laura Travan
Cristina Bibalo
Antonella Trappan
author_sort Francesca Cossovel
collection DOAJ
description Objectivesthe study aims to determine whether real-time ultrasound-guided umbilical venous catheter (UVC) insertion could enhance the accuracy of the procedure and reduce the number of x-ray, thereby minimizing radiation exposure of the newborn.MethodsA pre-post study was conducted, comparing outcomes before and after the introduction of ultrasound during catheter placement. All included newborns required placement of the UVC. In the study population (interventional group) the catheter tip was visualized using both ultrasound and radiography, whereas in the in historical cohort (control group) the catheter tip was visualized solely through radiography. Exclusion criteria included hemodynamic instability, known vascular malformations and major congenital malformations.ResultsDuring the study period, 33 eligible neonates underwent tip navigation and were enrolled, all of whom had a centrally-placed UVC. Additionally, 36 newborns were retrospectively identified as control group. The median gestational ages were 34 weeks and 33 weeks respectively for the interventional and control group (p 0.74). The median birth weights were 2,087 (1,400–3,220) g and 1,966 (1,489–2,695) g respectively for the interventional and control group (p 0.67). The catheter was correctly positioned at first attempt in 29/33 (87%) patients with US guidance and 17/36 (47%) in the control group (p < 0.001). The mean numbers of x-rays taken were 1.1 and 1.8 respectively for the interventional and control group (p < 0.001). In the control group, the mean number of antero-posterior thoracoabdominal radiograph (TAR) ranged from 1 to 3 for each patient.ConclusionIn conclusion, ultrasound could be the standard of care for umbilical catheter placement, ensuring accurate vessel assessment and real-time visualization. Despite our limited sample, our findings highlight its superior precision and safety, reducing complications and the need for radiography. Integrating ultrasound into daily neonatal practice can improve catheter placement and patient outcomes.
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spelling doaj-art-d18d9855e04b4725b241d9c822cd91752025-08-20T03:52:48ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-05-011310.3389/fped.2025.15675861567586Real-time ultrasound enhances umbilical venous catheters placement in preterm newbornsFrancesca Cossovel0Francesca Galdo1Luca Ronfani2Laura Travan3Cristina Bibalo4Antonella Trappan5Neonatal Intensive Care Unit, Institute of Child and Maternal Health, IRCSS Burlo Garofolo, Trieste, ItalyNeonatal Intensive Care Unit, Institute of Child and Maternal Health, IRCSS Burlo Garofolo, Trieste, ItalyPublic Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, ItalyNeonatal Intensive Care Unit, Institute of Child and Maternal Health, IRCSS Burlo Garofolo, Trieste, ItalyCommunity Medicine, University Hospital Giuliano Isontino, Gorizia, ItalyNeonatal Intensive Care Unit, Institute of Child and Maternal Health, IRCSS Burlo Garofolo, Trieste, ItalyObjectivesthe study aims to determine whether real-time ultrasound-guided umbilical venous catheter (UVC) insertion could enhance the accuracy of the procedure and reduce the number of x-ray, thereby minimizing radiation exposure of the newborn.MethodsA pre-post study was conducted, comparing outcomes before and after the introduction of ultrasound during catheter placement. All included newborns required placement of the UVC. In the study population (interventional group) the catheter tip was visualized using both ultrasound and radiography, whereas in the in historical cohort (control group) the catheter tip was visualized solely through radiography. Exclusion criteria included hemodynamic instability, known vascular malformations and major congenital malformations.ResultsDuring the study period, 33 eligible neonates underwent tip navigation and were enrolled, all of whom had a centrally-placed UVC. Additionally, 36 newborns were retrospectively identified as control group. The median gestational ages were 34 weeks and 33 weeks respectively for the interventional and control group (p 0.74). The median birth weights were 2,087 (1,400–3,220) g and 1,966 (1,489–2,695) g respectively for the interventional and control group (p 0.67). The catheter was correctly positioned at first attempt in 29/33 (87%) patients with US guidance and 17/36 (47%) in the control group (p < 0.001). The mean numbers of x-rays taken were 1.1 and 1.8 respectively for the interventional and control group (p < 0.001). In the control group, the mean number of antero-posterior thoracoabdominal radiograph (TAR) ranged from 1 to 3 for each patient.ConclusionIn conclusion, ultrasound could be the standard of care for umbilical catheter placement, ensuring accurate vessel assessment and real-time visualization. Despite our limited sample, our findings highlight its superior precision and safety, reducing complications and the need for radiography. Integrating ultrasound into daily neonatal practice can improve catheter placement and patient outcomes.https://www.frontiersin.org/articles/10.3389/fped.2025.1567586/fullumbilical cathetersultrasoundpositioncatheter tipradiography
spellingShingle Francesca Cossovel
Francesca Galdo
Luca Ronfani
Laura Travan
Cristina Bibalo
Antonella Trappan
Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
Frontiers in Pediatrics
umbilical catheters
ultrasound
position
catheter tip
radiography
title Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
title_full Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
title_fullStr Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
title_full_unstemmed Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
title_short Real-time ultrasound enhances umbilical venous catheters placement in preterm newborns
title_sort real time ultrasound enhances umbilical venous catheters placement in preterm newborns
topic umbilical catheters
ultrasound
position
catheter tip
radiography
url https://www.frontiersin.org/articles/10.3389/fped.2025.1567586/full
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