ĐÁNH GIÁ VAI TRÒ CỦA SIÊU ÂM BỤNG TRONG XÁC ĐỊNH VỊ TRÍ CỦA ỐNG THÔNG TĨNH MẠCH RỐN Ở TRẺ SƠ SINH

Abstract

Background: The umbilical venous catheter (UVC) is a common central line in neonatal department for administering fluids, medications, and blood products in neonates. However, malpositioning of the catheter can lead to various liver complications such as portal vein thrombosis, hepatic necrosis, and hepatic hematomas, etc. Currently, frontal chest-abdominal X-ray (CXR) is used to confirm the UVC placement. However, this invasive method is inconvenient for both infants and healthcare workers, and can not monitor catheter migration post-insertion. Ultrasound (US) is an easy, harmless method to check the position and detect complications, as well as monitor catheter movement. However, the use of ultrasound to determine the position of the umbilical vein catheter is not popular in Vietnam. Nevertheless, the use of ultrasound to verify UVC position is not yet common in Vietnam. Objective: To evaluate the position of umbilical venous catheters using abdominal ultrasound compared with frontal chest-abdominal X-ray. Methods: A cross-sectional descriptive study. The study included 77 neonates who were underwent UVC placement at Quang Ngai Hospital for Children and Women from June 2024 to October 2024. Results: There was a difference in UVC position identification between the CXR and US methods (p < 0.001). Ultrasound detected 6 cases of malpositioned UVCs while properly placed result on X-ray. Complications involving the liver occurred in 44.2% of cases, primarily when the UVC was located in a peripheral position. Conclusion: Determination the location of the UVC with abdominal ultrasound is quite accurate, while chest-abdominal X-rays determine the location of UVC less accurately. Ultrasound should be widely used in determining the location of the umbilical vein catheter.