PROPER LOCALIZATION OF UMBILICAL ARTERIAL AND VENOUS CATHETERS BY LATERAL ROENTGENOGRAMS

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Abstract
Widespread use of umbilical arterial and venous catheters to monitor the acid-base status of sick newborn infants has made proper placement of such catheters mandatory. Clinical assessment of their placement is poor. Radiographic localization is simple with anteroposterior and most important lateral films of the chest and abdomen. The venous and arterial course is totally different since the vein ascends anteriorly, while the artery descends to join the pelvic arteries before a posterior ascent into the aorta. The lateral film is optimal to identify inadvertent venous catheterization of a mesenteric vein or a wedged portal vein site. The lateral arterial view allows correction should the catheter slip into the ductus arteriosus and pulmonary arteries. The arterial catheter placement is felt to be best situated either in the chest below the ductus or in the abdomen below the major arteries to avoid either irritation of their ostia or injection of highly alkaline agents into the kidneys or intestines.

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