Echocardiographic evaluation of umbilical venous catheter placement

J Perinatol. 2003 Jan;23(1):24-8. doi: 10.1038/


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 pO(2) 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.

MeSH terms

  • Catheterization, Peripheral*
  • Catheters, Indwelling
  • Echocardiography*
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Respiratory Distress Syndrome, Newborn / therapy
  • Umbilical Veins*