{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:36:09Z","timestamp":1791401769556,"version":"4.3.3"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Epicutaneo-caval catheters (ECCs) are essential for the care of sick infants who require long-term medical and nutritional management. The aim of this study was to investigate the use of real-time ultrasound as an alternative to X-rays to reduce the incidence of primary malpositions during catheter insertion.<\/jats:p><jats:p>\n            Study Design\u2003Data on ECCs were retrospectively collected in a tertiary neonatal intensive care unit. Catheter were analyzed considering the tip location technique (standard chest\u2013abdominal radiograph vs real-time ultrasound)<\/jats:p><jats:p>\n            Results\u2003A total of 248 ECCs were analyzed. Of these, 118 catheters had primary malposition (47.6%). The tip of 165 catheters was assessed using standard chest\u2013abdominal X-rays and 107 (64.8%) were found to be in an inappropriate location. In the group of 83 catheters that were placed using real-time ultrasound for tip location, only 11 catheters (13.2%) had primary malposition. The rate of malposition among the two groups showed a statistically significant difference (p\u2009&lt;\u20090.001). Hypothetically, 300 chest X-rays could have been saved if real-time ultrasound had been used to locate the tip, reducing radiation exposure to infants.<\/jats:p><jats:p>\n            Conclusion\u2003The use of a real-time ultrasound may be beneficial in reducing primary catheter malpositions compared with conventional radiography. In addition, secondary malpositions and catheter-related complications can be monitored over time.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1760744","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T23:35:25Z","timestamp":1674603325000},"page":"e1183-e1189","source":"Crossref","is-referenced-by-count":13,"special_numbering":"S","title":["Real-Time Ultrasound Tip Location Reduces Malposition and Radiation Exposure during Epicutaneo-Caval Catheter Placement in Neonates"],"prefix":"10.1055","volume":"41","author":[{"given":"Vito","family":"D'Andrea","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Prontera","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cota","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosellina","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, UOC Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Barone","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital, Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vento","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,1,24]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1038\/s41372-019-0575-7","article-title":"Risk factors for peripherally inserted central catheter complications in neonates","volume":"40","author":"G C Pet","year":"2020","journal-title":"J Perinatol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1891\/0730-0832.29.1.23","article-title":"Are supine chest and abdominal radiographs the best way to confirm PICC placement in neonates?","volume":"29","author":"N Sneath","year":"2010","journal-title":"Neonatal Netw"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1053\/adnc.2002.36826","article-title":"Assessment of infants with peripherally inserted central catheters: Part 1. 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Nadroo","year":"2001","journal-title":"J Pediatr"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1542\/peds.110.1.137","article-title":"Pericardial effusion and tamponade in infants with central catheters","volume":"110","author":"T T Nowlen","year":"2002","journal-title":"Pediatrics"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1038\/sj.jp.7210541","article-title":"Central venous catheter tip in the right atrium: a risk factor for neonatal cardiac tamponade","volume":"21","author":"J C Darling","year":"2001","journal-title":"J Perinatol"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1111\/j.1460-9592.2007.02258.x","article-title":"The carina is not a landmark for central venous catheter placement in neonates","volume":"17","author":"G Inagawa","year":"2007","journal-title":"Paediatr Anaesth"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"F44","DOI":"10.1136\/fn.89.1.F44","article-title":"Long line positioning in neonates: does computed radiography improve visibility?","volume":"89","author":"A Evans","year":"2004","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1007\/s00383-020-04712-1","article-title":"CT validation of SVC-RA junction location for pediatric central line placement: is vertebral bodies below the carina accurate?","volume":"36","author":"J R Hirschl","year":"2020","journal-title":"Pediatr Surg Int"},{"issue":"06","key":"ref13","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1055\/s-0035-1570341","article-title":"Migration of central venous catheters in neonates: a radiographic assessment","volume":"33","author":"R Gupta","year":"2016","journal-title":"Am J Perinatol"},{"issue":"07","key":"ref14","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1111\/apa.12245","article-title":"Echocardiography allows more accurate placement of peripherally inserted central catheters in low birthweight infants","volume":"102","author":"L Tauzin","year":"2013","journal-title":"Acta Paediatr"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1038\/jp.2013.141","article-title":"Diagnostic ionizing radiation exposure in premature patients","volume":"34","author":"M V Scott","year":"2014","journal-title":"J Perinatol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"365","DOI":"10.7326\/0003-4819-158-5-201303051-00001","article-title":"The top patient safety strategies that can be encouraged for adoption now","volume":"158","author":"P G Shekelle","year":"2013","journal-title":"Ann Intern 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