The Role of Ultrasound in Epicutaneo-Caval Catheter Insertion in Neonates: Systematic Review, Meta-Analysis and Future Perspectives

Abstract

Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has been the subject of many recent studies. This systematic review investigates the accuracy of epicutaneo-caval catheter tip location by comparing ultrasound and conventional radiology. We performed a systematic literature search in multiple databases. The selection of studies yielded nineteen articles. The systematic review and meta-analysis were performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis). The analyses showed that ultrasound is a better imaging technique for epicutaneo-caval catheter tip location in the neonatal intensive care unit than conventional radiology. By improving operator training and selecting a standardized echography protocol, ultrasound could become the gold standard for visualizing the epicutaneo-caval catheter tip in the neonatal intensive care unit. This would have some important benefits: (1) increased accuracy in tip location (2); a more rapid use of the central venous access (3); and a significant reduction in radiation exposure.

The advantage of point-of-care ultrasound in central venous catheterization and related pericardial effusion in infants in the NICU

“…POCUS can improve the rapid diagnosis of PCE and pericardial tamponage and other critical conditions, reduce radiation exposure, strengthen the continuous monitoring of CVCs (28). Ultrasound can be performed in real time and is the optimal technique for CVC tip positioning in infants (29,30). Neonatologists can accurately localize the CVC tip and evaluate the hemodynamic and cardiac function (31).…”

Ultrasound-Guided Centrally Inserted Central Catheter (CICC) Placement in Newborns: A Safe Clinical Training Program in a Neonatal Intensive Care Unit

“…Central Venous Catheters (CVCs) are fundamental intravascular devices in preterm and term infants admitted to neonatal intensive care units (NICUs). CVCs are defined as Central Venous Access Devices (CVADs) placed by cannulation of deep veins that lie deeper than 7 mm from the surface of the skin [1]. A CVAD is defined as when the tip is located at the atriocaval junction or in the inferior vena cava [2].…”