The aortic valve as a landmark for ultrasound guided umbilical artery catheter placement, a prospective retrospective controlled study

Objective: Umbilical artery catheters (UAC) are common in the neonatal intensive care unit. Catheters are often re-adjusted and require multiple X-rays. Point of care ultrasound (POCUS) is reliable and safe. The objective of this study was to determine if visualizing the aortic valve (AoV) with POCUS could be a landmark for UAC positioning. Study Design: This was a prospective, retrospective controlled study. The retrospective group included neonates with a UAC insertion depth calculated by (3×birth weight(kg)+9). The experimental group used POCUS and identified the level of the AoV for UAC placement. Results: Each group had thirty neonates and were similar in gestational age, and median birth weight. In the control group, 16 neonates (53%) required repositioning and between 2 and 6 X-Rays. None of the UACs in the experimental group needed repeat X-Rays (p < 0.001). Conclusion: The AoV location identified using POCUS can reduce the need for multiple XRs for UAC placement.