The Role of Ultrasound in Epicutaneo-Caval Catheter Insertion in Neonates: Systematic Review, Meta-Analysis and Future Perspectives
Vito D’Andrea,
Valentina Cascini,
Rosellina Russo,
Alessandro Perri,
Giorgia Prontera,
Gina Ancora,
Giovanni Vento,
Gabriele Lisi,
Giovanni Barone
Affiliations
Vito D’Andrea
Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Valentina Cascini
Pediatric Surgery Unit, Hospital Spirito Santo, 65124 Pescara, Italy
Rosellina Russo
Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology, Neuroradiology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Alessandro Perri
Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Giorgia Prontera
Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Gina Ancora
Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital, 47923 Rimini, Italy
Giovanni Vento
Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Gabriele Lisi
Pediatric Surgery Unit, Hospital Spirito Santo, 65124 Pescara, Italy
Giovanni Barone
Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital, 47923 Rimini, Italy
Chest and abdominal X-rays after the insertion of an epicutaneo-caval catheter in infants are the standard method of checking the tip location in many neonatal intensive care units. The role of ultrasound in the tip location of the epicutaneo-caval catheter in neonates has been the subject of many recent studies. This systematic review investigates the accuracy of epicutaneo-caval catheter tip location by comparing ultrasound and conventional radiology. We performed a systematic literature search in multiple databases. The selection of studies yielded nineteen articles. The systematic review and meta-analysis were performed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analysis). The analyses showed that ultrasound is a better imaging technique for epicutaneo-caval catheter tip location in the neonatal intensive care unit than conventional radiology. By improving operator training and selecting a standardized echography protocol, ultrasound could become the gold standard for visualizing the epicutaneo-caval catheter tip in the neonatal intensive care unit. This would have some important benefits: (1) increased accuracy in tip location (2); a more rapid use of the central venous access (3); and a significant reduction in radiation exposure.
