Use of Point of Care Ultrasound for Confirming Central Line Tip Position in Neonates

Abstract

To assess feasibility of ultrasound (USG) evaluation of tip position of central catheter in neonates and to determine agreement between radiograph and USG-based assessments. This prospective observational study was conducted in a tertiary neonatal intensive care unit from April, 2019 to August, 2019. Point of care USG and radiograph were performed on infants who underwent central line placement. Agreement between the two was determined using Kappa statistics. Of the 141 central catheters insertions performed, USG was performed for 65 central catheters. On USG, catheter tip position could be assessed and defined in 62 (95%) of cases. Of these 62 central lines, 24 (38.7%) were defined as optimally placed on radiograph and 20 (32.2%) were defined as optimally placed on USG. There was excellent agreement between radiographic and USG assessment of catheter tip position [K (95% CI) = 0.86 (0.73-0.99), P <0.001]. All 38 lines found to be mal-positioned on radiograph were assessed as sub-optimal on USG as well. Point of care USG has excellent agreement with radiography for confirming central line tip position.