ULTRASOUND-GUIDED PERCUTANEOUS CENTRAL VENOUS CATHETERIZATION IN PRETERM INFANTS

Percutaneous central venous catheterization is commonly performed in very premature babies, in whom parenteral nutrition via a central vein is required to ensure adequate growth. The value of using ultrasound guidance rather than roentgenograms for percutaneous central venous catheterization was evaluated prospectively in ten premature neonates with gestational ages of 26 to 31 weeks and birth weights of 960 to 1570 g. Dynamic ultrasonography with transverse oblique views was used. Accurate, real-time positioning of the catheter tin in the right atrium was achieved in all ten infants. In two cases, ultrasonography allowed to correct catheter progression In the wrong vein. Ultrasound data consistently agreed with roentgenographic data. Ultrasonography may be the better technique because it allows real-time monitoring of catheter position, saving valuable time. The greater precision of ultrasound monitoring and absence of radiation exposure are additional advantages. Furthermore, ultrasound can be performed repeatedly to monitor the catheter and detect complications.