Neo-ECHOTIP: A structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in neonates

Central venous access devices are often needed in neonates admitted to Neonatal Intensive Care Unit. The location of the tip of the central catheter is usually assessed by post-procedural X-ray. However, this strategy is inaccurate and time consuming. Recent guidelines strongly recommend intra-procedural methods of tip location, to increase the cost-effectiveness of the maneuver and to shorten the time between device placement and utilization. In this regard, real-time ultrasound represents the most promising tool for tip navigation and location in neonates. The aim of this paper is (a) to review all the evidence available about ultrasound-based tip navigation and tip location of central catheters in the neonatal population (b) to propose a novel protocol for tip navigation and location (Neo-ECHOTIP) based on such evidence.

Automated summary

Central venous access devices are often required for neonates in the Neonatal Intensive Care Unit. Post-procedural X-ray assessment of the catheter tip location is inaccurate and time-consuming, therefore intra-procedural ultrasound navigation is recommended for more cost-effective and timely placement. Real-time ultrasound is considered the most promising tool for tip navigation in neonates, allowing for quicker and more accurate location of central catheter tips.