Positioning long lines: contrast versus plain radiography

Abstract

Aim-To assess the value of contrast versus plain radiography in determining radio-opaque long line tip position in neonates. Methods-In a prospective study, plain radiography was performed after insertion of radio-opaque long lines. If the line tip was not visible on the plain film, a second film with contrast was obtained in an attempt to visualise the tip. Results-Sixty eight lines were inserted during the study period, 62 of which were included in the study. In 31, a second radiographic examination with contrast was necessary to determine position of the tip. In 29 of these, the line tip was clearly visualised with contrast. On two occasions, the line tip could not be seen because the contrast had filled the vein and obscured the tip from view. Eight of the lines that required a second radiograph with contrast were repositioned. Conclusion-Intravenous contrast should be routinely used in the assessment of long line position in the neonate. (Arch Dis Child Fetal Neonatal Ed 2001;84:F129-F130)

The Cobweb Sign: Percutaneous Silastic Long Line Tip Placement in Tributaries of Superficial Veins

“…In contrast, in the tributaries of the venous plexae around the pelvis and vertebral column there are no valves and blood can flow both towards and away from the heart. 8 Reece et al 6 reported that the position of the narrow calibre silastic catheter tip could not be determined accurately in 50% of plain radiographs and suggested the use of contrast medium to improve radio-opacity. Each of our cases demonstrate that the flow of the contrast medium from the tip of catheter could be traced along more than one line and away from the centre of the body.…”

“…The exact site of the line tip can be confirmed by contrast X-ray. [6][7] When the long line is placed properly in one of the major superficial or deep veins the contrast medium can be traced streaming from the tip of the line towards the centre of the body in a single line.…”

12th European Workshop on Neonatology

“…Background: Positioning long lines in neonates is a common problem. The gold standard is the plain radiography with or without contrast [1,2]. Control of the position of the tip of the catheter is necessary because some complications can be life threatening.…”

“…Serum creatinine increased in only 1 patient; on the contrary, Cystatin C increased in 5 patients. Conclusions: NSAIDs seems a major cause of drug-induced acute renal failure in preterm infants [2]. An early diagnosis is essential to prevent kidney damage and Cystatin C increases in the so called blind-creatinine period [3].…”

“…Although the incidence of CHD in neonates conceived with IVF was 1.5 times higher, the difference was not significant (p = 0.45). In the IVF group, 3/139 (2.2%) infants had chromosomal abnormalities (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18); all 3 had CHD. There were no caryotypic abnormalities in the 230 neonates conceived naturally (p = 0.05).…”