Introduction: Umbilical 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.Methods: We 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.Results: Correct 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.Discussion: Real-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.

Objective: Thrombosis is a common complication of umbilical artery catheterization. The purpose of this study was to compare the novel ultralow umbilical artery catheter position (catheter tip at the junction of the umbilical and internal iliac arteries) versus the conventional high umbilical artery catheter position (tip in the aorta, above the diaphragm) for the incidence of thrombosis. Study design: This study was conduct- ed in a nonacademic, tertiary-referral neonatal center. The insertion and placement of the umbilical artery catheter was performed under continuous ultrasound guidance. Serial ultrasound examinations were per- formed to identify thrombosis in 38 consecutive newborns with an umbilical artery catheter placed in the novel ultralow position. The control group consisted of 50 infants with an umbilical artery catheter placed in the standard position. Results: The incidence of thrombosis requiring anticoagulant treatment was 22% in neonates with an umbilical artery catheter in the standard position. No thrombosis was detected in those with an umbilical artery catheter placed in the ultralow position. The study and control groups had similar catheter indwelling times (mean, 8.2 ± 4.1 vs. 8.5 ± 4.0 days, p = 0.687). Conclusions: This is the first report to present a novel position for the placement of umbilical artery catheters. The preliminary findings for the novel ultralow umbilical artery catheter position indicate that it may provide a safety benefit over the conventional umbilical artery catheter position.

Background: Umbilical venous catheter (UVC) placement is common in neonates but carries risks of migration and infection. This study evaluates safety of a novel fixation technique using the umbilical cord clamp after a side-entry insertion. Methods: A retrospective analysis of 264 neonates was conducted at a tertiary center in order to assess safety of the novel UVC fixation method. The new technique involved side-entry catheter insertion without severing the cord, secured to the clamp with a sterile patch. Catheter tip position was confirmed and monitored every 24 h via ultrasound. Results: Catheter migration occurred in 18.9% of cases, mostly inward into the right atrium which was managed by repositioning. Migration into the ductus venosus requiring removal occurred in 0.7% of cases and unscheduled removal due to stump detachment in 1.5%. No central line-associated bloodstream infections (CLABSIs) were observed. Conclusions: The umbilical cord clamp method is a safe, single-operator alternative for UVC fixation. This technique had a low rate of catheter migration, did not increase the risk of infection, and was cost-effective and simple.

Background: Umbilical arterial catheterisation is a routine procedure in neonatal intensive care units but is associated with thrombotic and other complications. This study evaluated the safety of an innovative ultralow umbilical artery catheter (UL-UAC) positioning technique in a cohort of 235 neonates. Methods: This retrospective study assessed acute complications and thrombotic events following UAC placement with the UL-UAC technique, in which the catheter tip is positioned at the junction of the umbilical and internal iliac arteries under real-time ultrasound guidance. All catheter-related adverse events were recorded. Results: No thrombotic complications were observed. Other adverse events, including minor bleeding after catheter removal, accidental dislodgment and central line-associated bloodstream infections (CLABSI), occurred in only 4.8% of cases. Conclusions: The ultrasound-guided UL-UAC method is safe and has the potential to reduce the risk of thrombosis while maintaining a low overall complication rate, therefore it can be considered an alternative to the standard and well-established technique.