Summary
Umbilical vascular catheters are often necessary in the care of critically ill neonates. Position of the catheter tip is usually determined by roentgenography. Location of the umbilical arterial or venous catheter was determined by 2-dimensional echocardio/aortography in 55 consecutive infants and was compared to localization by thoraco-abdominal roentgenography. Most of the infants (76%) had respiratory distress syndrome or congenital heart disease.
Echoaortographic localization of the umbilical arterial catheter correlated very closely (N = 50, r = .90) with roentgenographic determination. For localization of the tip of the umbilical venous catheters, echocardiography was more accurate than roentgenography (employing contrast echocardiography for confirmation of cardiac chamber position).
Two-dimensional echocardio/aortographic localization of the tip of indwelling umbilical vascular catheters is as accurate as roentgenography in the arterial system and more accurate than x-ray for umbilical venous catheters. Echocardio/aortography is superior to roentgenography (in localizing the catheter tip) because it 1) avoids ionizing radiation, 2) makes positioning of the patient unnecessary, 3) allows visualization of the catheter in relation to cardiovascular structures, and 4) may allow demonstration of intraarterial thrombo-emboli.
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References
Baker DH, Berdon WE, James LS: Proper localization of umbilical arterial and venous catheters by lateral roentgenograms.Pediatrics 43:34–39, 1969
Campbell RE: Roentgenologic features of umbilical vascular catheterization in the newborn.Am J Roentgenol Radium Ther Nucl Med 112:68–76, 1971
Charuzi Y, Kraus R, Swan HJC: Echocardiographic interpretation in the presence of Swan-Ganz intracardiac catheters.Amer J Cardiol 40:989–994, 1977
Cochran WD: Umbilical artery catheterization, iatrogenic problems in neonatal intensive care,Report of the Sixty-Ninth Ross Conference on Pediatric Research. Edited by TD Moore, Columbus, Ohio, Ross Laboratories, 1976, pp 28–31
Dunn PM: Localization of the umbilical catheter by postmortem measurement.Arch Dis Child 41:69–75, 1966
Fisher E, Sepehri B, Bhat R, Vidyasager D, Flanigan DP: Noninvasive diagnosis of abdominal aortic thrombosis in newborn by real-time two-dimensional echoaortography (Abst.)Circ 62:III-74, 1980
George L, Waldman JD, Kirkpatrick SE, Turner SW, Pappelbaum SJ: Two-dimensional echocardiographic visualization of the aortic arch by right parasternal scanning in neonates and infants.Pediatr Cardiol, in press
Gramiak R, Shah PM, Kramer DH: Ultrasound cardiography: Contrast studies in anatomy and function.Radiology 92:939–948, April 1969
Grant JCB:An Atlas of Anatomy (Williams and Wilkins, Baltimore, 1972). Figure 189.1
Kitterman JA, Phibbs RH, Tooley WH: Catheterization of umbilical vessels in newborn infants.Pediatr Clin North Am 17:895–912, 1970
Mikell FL, Asigner RW, Rourke T, Hodges M, Sharma B, Francis GS: Two-dimensional echocardiographic demonstration of left atrial thrombi in patients with prosthetic mitral valves.Circ 60:1183–1190, 1979
Mokrohisky ST, Levine RL, Bumhagen JD, Wesenberg RL, Simmons MA: Low positioning of umbilical artery catheters increases associated complications in newborn infants.N Engl J Med 299:561–564, 1978
Paster S, Middleton P: Roentgenographic evaluation of umbilical artery and vein catheters.JAMA 231:742–746, 1975
Perry LW, Galioto FM, Blair T, Shapiro SR, Ruckman RN, Scott LP: Two-dimensional echocardiography for catheter location and placement.Pediatrics 67:541–547, 1981
Phelps DL, Lachman RS, Leake RD, Oh W: The radiologic localization of the major aortic tributaries in the newborn infant.J Pediatr 81:336–339, 1972
Pietro DA, Parisi AF: Intracardiac masses. Tumors, vegetations, thrombi and foreign bodies.Med Clin N Am 64:239–251, March 1980
Pollitzer MJ, Soutter LP, Reynolds EP: Continuous monitoring of arterial oxygen tension in infants: Four years' experience with an intravascular oxygen electrode.Pediatr 66:31–36, 1980
Reeves WC, Nanda NC, Barold SS: Echocardiographic evaluation of intracardiac pacing catheters: M-mode and two-dimensional studies.Circ 58:1049–1056, 1978
Rosen MS, Reich SB: Umbilical venous catheterization in the newborn: Identification of correct positioning.Radiology 95:335–340, 1970
Speidel BD: Adverse effects of routine procedures on preterm infants.Lancet 1:864–866, April 1978
Symansky MR, Fox HA: Umbilical vessel catheterization: Indications, management and evaluation of the technique.J Pediatr 80:820–826, 1972
Tajik AJ, Seward JB, Hagler DJ, Mair DD, Lie JT: Two-dimensional real-time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification and validation.Mayo Clin Proc 53:271–303, 1978
Umbilical artery catheters (Letters).N Engl J Med 300:316–317, 1979
Waldman JD, Rummerfield PE, Gilpen EA, Kirkpatrick SE: Radiation exposure to the child during cardiac catheterizationCirc 64:158–163, 1981
Weber AL, DeLuca S, Shannon DC: Normal and abnormal position of the umbilical artery and venous catheter on the roentgenogram and review of complications.Am J Roentgenol Radium Ther Nucl Med 120:361–367, 1974
Wesstrom G, Finnstrom O, Stenport G: Umbilical artery catheterization in newborns. I. Thrombosis in relation to catheter type and position.Acta Paediatr Scand 68:575–581, 1979
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George, L., Waldman, J.D., Cohen, M.L. et al. Umbilical vascular catheters: Localization by two-dimensional echocardio/aortography. Pediatr Cardiol 2, 237–243 (1982). https://doi.org/10.1007/BF02332115
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DOI: https://doi.org/10.1007/BF02332115