AUTHOR=Tomaszkiewicz Anna , Kruczek Piotr , Szymański Piotr , Walczak Krystian , Teplicki Piotr , Sobczak Alina , Mazela Jan 

TITLE=Real-time ultrasound guidance improves neonatal umbilical venous catheter placement efficiency and reduces liver complications

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2025.1655820

DOI=10.3389/fped.2025.1655820

ISSN=2296-2360

ABSTRACT=IntroductionUmbilical venous catheters (UVCs) are essential in neonatal intensive care, yet blind insertion techniques remain common and increase the risk of malposition and liver injury. This study evaluated whether real-time ultrasound guidance improves UVC placement efficiency and safety.MethodsWe retrospectively analysed 305 neonates who underwent ultrasound-guided UVC placement between July 2023 and January 2025 in a tertiary neonatal unit. The primary outcome was successful tip placement in the subdiaphragmatic vestibule; the secondary outcome was acute catheter-related liver injury.ResultsCorrect catheter placement was achieved in 86.56% of cases, with a gradual improvement from 83.81% to 89.12% over time. Only one hepatic haematoma was observed, and no other acute complications occurred.DiscussionReal-time ultrasound guidance significantly enhances the accuracy and safety of UVC insertion in neonates, minimising hepatic injury risk. Further research should assess its role in prolonged catheter monitoring.