{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:12:04Z","timestamp":1790208724026,"version":"4.1.0"},"reference-count":35,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neonatology"],"abstract":"<jats:p>&lt;p&gt;Introduction: There is a growing interest in ultrasound-guided central catheter (CC) tip-position, driven by its potential to improve accuracy and reduce complications. We aimed to systematically review and meta-analyze studies that reported complications associated with ultrasound-guided versus radiography-guided CC tip-position in neonates. Methods: We searched Medline, Cochrane, Embase, CINAHL, and &lt;ext-link ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\"&gt;clinicaltrials.gov&lt;\/ext-link&gt; for randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing the complications of ultrasound- versus X-ray-guided CC tip-position in neonates up to June 2024. RCTs and NRSs were analyzed separately. The outcomes included malposition, number of X-rays, procedure time, catheter manipulation, cardiac tamponade, extravasation, occlusion, and sepsis rates. Subgroup meta-analysis based on catheter type was performed. Statistical analyses were conducted using Review Manager 5.4.1 and R 4.1.0, and the GRADE methodology was applied to assess evidence certainty. Results: Eight studies (4 RCTs and 4 NRSs, N = 1,322 neonates) were included. Ultrasound-guided catheter tip-position significantly reduced malposition rates (3 RCTs, N = 181, RR: 0.51, 95% CI: 0.37 to 0.70; 4 NRSs, N = 1,110, RR: 0.25, 95% CI: 0.11 to 0.57) and decreased the need for X-rays (2 RCTs, N = 112, MD: \u22121.22, 95% CI: \u22122.32 to \u22120.11; 2 NRSs, N = 401, MD: \u22120.31, 95% CI: \u22120.47 to \u22120.15). No significant differences were found in procedure time, catheter manipulation, or sepsis rates. All evidence was of low certainty per grade. Conclusions: The use of ultrasound-guided CC tip-position in neonates is associated with a reduction in malposition rates and radiation exposure (low certainty evidence). Further research is needed to confirm the benefits of ultrasound-guided CC tip-position in neonates. &lt;\/p&gt;<\/jats:p>","DOI":"10.1159\/000545772","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T12:02:37Z","timestamp":1744200157000},"page":"537-547","source":"Crossref","is-referenced-by-count":5,"title":["Comparing Malposition and Complications Associated with Ultrasound-Guided versus Radiography-Guided Central Catheter Tip-Position in Neonates: A Systematic Review and Meta-Analysis"],"prefix":"10.1159","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8031-6627","authenticated-orcid":false,"given":"Adel","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Mohsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Solis-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehad","family":"Nasef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9920-0488","authenticated-orcid":false,"given":"Prakesh","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.987512"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1715117"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001218"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-022-04695-2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-006-0172-8"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.1.131"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2017-000128"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000863"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2014.240"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060053"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-022-05379-7"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2021.07.010"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0522"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.ED000142"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2010.128"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.58"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-018-0249-x"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-022-04295-w"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-022-04412-z"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1760744"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2023.07.008"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1159\/000538905"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2018.1437135"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311202"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000491"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-023-00832-1"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31819b570e"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2012.112"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002919"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-1401"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1569987"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-021-02822-w"}],"container-title":["Neonatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/neo\/article-pdf\/doi\/10.1159\/000545772\/4363923\/000545772.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000545772","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:01:12Z","timestamp":1760371272000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000545772"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":35,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10,13]]},"published-print":{"date-parts":[[2025,10,15]]}},"URL":"https:\/\/doi.org\/10.1159\/000545772","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.28749803","asserted-by":"subject"}]},"ISSN":["1661-7800","1661-7819"],"issn-type":[{"value":"1661-7800","type":"print"},{"value":"1661-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,9]]}}}