Study of a Comparison of Ultrasonography with Radiography to Localize the Umbilical Arterial Catheter

Choi, Byoung Min; Park, Young Kwan; Yoo, Kee Hwan; Hong, Young Sook; Lee, Joo Won; Kim, Soon Kyum

Abstract

PURPOSE: This study was performed to observe the utilization of ultrasonography in locating the position of UAC and to compare the position with anatomical landmarks seen on radiography.
METHODS
Optimal position is when the catheter tip is located between T6-T10 or L3-L5 by anteroposterior radiography (AP-R) and above the diaphragm by cross-table lateral radiography (CTL-R). Ultrasonographic studies used a Hewlett Packard Sonos 1000 with 5 MHz scanner, the distance from the catheter tip to the origin of the celiac artery in high position and the distance from the catheter tip to the origin of the renal arteries and to the aortic bifurcation in low position were measured.
RESULTS
In 23 of 36 newborns, high type UAC was properly positioned by AP-R, but ultrasonographic examination showed that 3 UAC were malpositioned under 5mm above the origin of the celiac artery. Detection of properly positioned UAC by AP-R had a sensitivity of 80% and specificity of 72.7%. In 19 of 28 newborns, high type UAC was properly positioned by CTL-R, but ultrasonographic examination showed that 2 UAC were malpositioned under 5mm above the origin of the celiac artery. Detection of properly positioned UAC by CTL-R had a sensitivity of 81% and specificity of 71.4%. In 15 of 20 newborns, low type UAC was properly positioned by AP-R, and ultrasonographic examination showed that 1 UAC was malpositioned below the aortic bifurcation. Detection of properly localized UAC by AP-R had a sensitivity of 77.8% and specificity of 50%.
CONCLUSION
Ultrasonographic catheter localization is a noninvasive technique that uses no ionizing radiation and has no known deterimental side effects, and allows direct visualization of the pertinent vascular anatomy, providing more information than traditional radiography.