{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:36:08Z","timestamp":1777876568259,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>International guidelines recommend point-of-care ultrasonography (POCUS) in neonatology for diagnostic, therapeutic, and procedural purposes. However, there are few standard protocols for using POCUS to confirm lower extremity catheter tip positioning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, subcutaneously tunneled femorally inserted central catheters (ST-FICCs) were placed in eligible neonates according to physician orders. In line with the Neo-ECHOTIP (NE) protocol, a subcostal longitudinal view was used to identify the catheter, and saline flush test (SFT) was performed to confirm catheter tip placement below the right atrium. During the study, a novel \u201cretract, advance, and position (RAP)\u201d technique was added to the existing NE-SFT protocol to improve catheter positioning. Two-view radiographs of the chest and abdomen were obtained to verify catheter tip position for all subjects. The agreement rate with post-procedural radiographs and the total number of radiographs needed to achieve proper catheter positioning were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The agreement rate of POCUS with radiographs for catheter terminal tip position was 75% (39\/52) for the NE-SFT group compared to 100% (48\/48) for the NE-SFT + RAP group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Catheters in the NE-SFT group required repositioning (25%); no malpositioned catheters were observed in the NE-SFT + RAP group. Repositioning of the catheter in the NE-SFT group resulted in 22 repeat radiographs in the NE-SFT group; none were required in the NE-SFT + RAP group (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This single-center study demonstrated that applying the RAP technique to the Neo-ECHOTIP protocol improved the ease and accuracy of lower extremity catheter tip position localization in neonates, thus eliminating the use of radiography.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798251318585","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T19:23:01Z","timestamp":1739301781000},"page":"110-118","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["POCUS using the neo-ECHOTIP protocol plus the retract, advance, and position (RAP) technique to improve lower extremity catheter positioning in neonates"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5417-5621","authenticated-orcid":false,"given":"M","family":"Ostroff","sequence":"first","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Abu-Ali","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4734-7493","authenticated-orcid":false,"given":"V","family":"DeBari","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Kiblawi","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-8613","authenticated-orcid":false,"given":"A","family":"Zauk","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Datta-Bhutada","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z","family":"Pua","sequence":"additional","affiliation":[{"name":"St. Joseph\u2019s Regional Medical Center, Paterson, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-2787-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.4717"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2007.11.007"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.107.2.e28"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2012.112"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2013.08.023"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.58"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1295649"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298211007703"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.11.016"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-022-04400-3"},{"key":"e_1_3_4_13_2","unstructured":"Ostroff M Abu-Ali J Zauk A et al. Transhepatic and subcostal ultrasound imaging for catheter location of subcutaneously tunneled mid-thigh femoral vein catheters in neonates. In 2023 the pediatric academic society conference annual meeting. Washington DC June 30 2023. 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