Echocardiographic evaluation of umbilical venous catheter placement

被引：101
作者：
Anne Ades
Craig Sable
Susan Cummings
Russell Cross
Bruce Markle
Gerard Martin
机构：
[1] Department of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA 19104
[2] Department of Neonatology, Children's National Medical Center, Washington, DC
[3] Department of Cardiology, Children's National Medical Center, Washington, DC
[4] Department of Radiology, Children's National Medical Center, Washington, DC
来源：
Journal of Perinatology | 2003年 / 23卷 / 1期
关键词：
D O I：
10.1038/sj.jp.7210851
中图分类号：
学科分类号：
摘要：
Objective: To compare techniques for guiding and confirming placement of umbilical venous catheters (UVCs) using two-dimensional echocardiography. Study design: Fifty-three newborns admitted to our neonatal intensive care unit who required an UVC or who were transferred within 24 hours of UVC placement at a referring hospital were studied. UVC position was assessed by antero-posterior (AP) chest radiography (CXR), lateral CXR, and oxygenation data. The accuracy of the above techniques was compared to echocardiography with saline contrast injection. Results: Echocardiography revealed that UVCs were located ideally at the right atrial/inferior vena cava junction in only 12 (23%) of 53 patients. Twenty-four (45%) were incorrectly positioned in the left atrium. The sensitivity and specificity of AP CXR in evaluating inappropriate UVC position were 32% and 89%, respectively. Lateral CXR and thoracic level on AP CXR did not predict accurately catheter position. UVC pO2 data were not useful in excluding left atrial placement. Conclusion: Current methods to determine insertion length and confirm location of UVCs are not adequate. Echocardiography should be considered to confirm correct placement of UVCs.
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页码：24 / 28
页数：4
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