Determination of Accurate Position of Umbilical Venous Catheters in Premature Infants

2020 ◽  
Author(s):  
Selahattin Akar ◽  
Emre Dincer ◽  
Sevilay Topcuoğlu ◽  
Taner Yavuz ◽  
Hatice Akay ◽  
...  
Keyword(s):  
Intensive Care ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
X Rays ◽  
X Ray ◽  
High Position ◽  
Umbilical Catheter ◽  
Chest X Ray ◽  
Accurate Position

Objective The aim of the study is to determine the most accurate length and position of umbilical venous catheter (UVC). Study Design This prospective study included premature infants who were admitted to the neonatal intensive care unit with inserted UVC between January 1, 2014 and December 31, 2015. The length of UVC was calculated according to the Shukla formula [(3 × birth weight + 9)/2 + 1] and the catheter was inserted under sterile conditions. After the insertion, umbilical catheter was first evaluated through chest X-ray and then with echocardiography to confirm its position. Catheters seen on the chest X-ray at the level of T9-T10 vertebrae were classified as “accurate position,” those seen above T9 vertebra as “high position,” and the catheters identified below T10 vertebra were classified as “low position.” Results A total of 68 infants smaller than 36 weeks of gestation were included in the study. In echocardiographic evaluation, 80% of the cases identified as in the “accurate position,” 100% of the cases classified as in a “high position,” and 33% of the cases defined as in a “low position” on the chest X-rays were found to be intracardiac. In our study, length of the catheter calculated according to the Shukla formula was intracardiac in 88.2% of premature infants. Conclusion Radiography alone is not sufficient for the determination of adequate position of umbilical catheter, especially in premature infants. Specialists practicing in neonatal intensive care units could improve themselves and evaluate UVC with echocardiography, making this a routine part of clinical practice. Echocardiography-guided fixation of the catheter will reduce the complications related to catheter malposition. Key Points

Radiation Exposure in the Neonatal Intensive Care Unit in Newborns and Staff

2021 ◽  
Author(s):  
Salih Cagri Cakir ◽  
Bayram Ali Dorum ◽  
Nilgun Koksal ◽  
Hilal Ozkan ◽  
Zeynep Yazici ◽  
...  
Keyword(s):  
Intensive Care ◽  
Radiation Exposure ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Diagnostic Procedures ◽  
Skin Dose ◽  
X Rays ◽  
X Ray ◽  
Radiation Induced ◽  
The Mean

Objective Portable X-rays remain one of the most frequently used diagnostic procedures in neonatal intensive care units (NICU). Premature infants are more sensitive to radiation-induced harmful effects. Dangers from diagnostic radiation can occur with stochastic effects. We aimed to determine the radiation exposure in premature infants and staff and determine the scattering during X-ray examinations in the NICU. Study Design In this prospective study, dosimeters were placed on premature infants who were ≤1,250 g at birth and ≤30 weeks of gestational age who stayed in the NICU for at least 4 weeks. The doses were measured at each X-ray examination during their stay. The measurements of the nurses and the doctors in the NICU were also performed with dosimeters over the 1-month period. Other dosimeters were placed in certain areas outside the incubator and the results were obtained after 1 month. Results The mean radiation exposure of the 10 premature infants, monitored with dosimeters, was 3.65 ± 2.44 mGy. The mean skin dose of the six staff was 0.087 ± 0.0998 mSV. The mean scattered dose was 67.9 ± 26.5 µGy. Conclusion Relatively high exposures were observed in 90% of the patients and two staff. The radiation exposure levels of premature infants and staff may need to be monitored continuously. Key Points

Role of Lung Ultrasound in the Diagnosis of Neonatal Respiratory Disorders

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nehal M El Raggal ◽  
laila A Hegazy ◽  
Hossam M Sakr ◽  
Yasmin A Farid ◽  
Osama A Eldafrawy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Lung Ultrasound ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray

Abstract lung ultrasound (LUS) was used traditionally in the assessment of pleural effusions and masses but LUS has moved towards the imaging of the pulmonary parenchyma, mainly as a point-of-care technique. Objective To assess the agreement between LUS and CXR for the diagnosis of RD in neonates. Methods This prospective cross sectional study was conducted on 100 neonates presents with RD in the first 24 hours of life in the neonatal intensive care unit (NICU) of the Ain Shams University. All enrolled neonates underwent LUS and CXR initially and on day 7. Neonatologists were blind to the LUS diagnosis and the clinical decisions were driven by CXR findings. Lung score was applied to describe lung aeration, interstitial, alveolar, or consolidation patterns for each lung area. Results 125 different diagnoses were reported in 100 patients. The total agreement between LUS and CXR diagnosis was 96% (95% CI 88–98%) with a κ statistic of 0.94 (95% CI 0.86– 1.00). The agreement for RDS, Pneumonia, TTN, MAS, CDH, PE, Pnumothorax and atelectasis were 99%, 96%,98%, 99%,100%,100%,98% and 98% consequently. Conclusion LUS is a safe, low coast, easy to operate and has high agreement with CXR for the diagnosis of RD in neonates in the first week of life. Key words Neonatal intensive care, Point-of-care ultrasound, Chest X-ray Abbreviations: NICU: Neonatal Intensive Care Unit, LUS: Lung ultrasound, CXR: Chest X ray, RDS: respiratory distress syndrome, TTN: Transient Tachypnea of Newborn, MAS: Meconium Aspiration, PE: pleural effusion, CDH: cong. diaphragmatic hernia.

scholarly journals The Role of Chest X-Ray in Intensive Care Unit

2021 ◽  
Vol 6 (01) ◽  
pp. 38-45
Author(s):  
Mayson Ahmed Wanasi Khair ◽  
Shouq Mohammed Alamri ◽  
Ahlam Hameed Alrashidi ◽  
Malak Abdulrahman Lharbi ◽  
Yosra Saleh Al-moghamsi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sample Size ◽  
Radiation Source ◽  
Small Sample ◽  
Pathologic Finding ◽  
X Rays ◽  
Icu Patients ◽  
X Ray ◽  
Chest X Ray

Purpose: Chest X-rays (CXRs) are the most common radiological tests performed in the intensive care unit (ICU). The purpose of the current study was to investigate the relationship between the performance CRX in ICU and the patient’s confirmed pathologic finding. Methods: This retrospective study was evaluated 50 ICU chest X-rays were retrieved from the Picture Archiving and Communication System (PACS) of the different Saudi Hospitals in Al-Medina (February - April 2017). Frequency Distribution, Ratio and Linear Regression were used for statistical analysis. Result: This study demonstrated that based on analyzing the data, 92% of chest X-ray requests were used among 50 ICU patients to confirm the diagnosis, and a significant relationship was found between the use of chest X-rays between the ICU patients and the patient's confirmed pathologic finding which may mean that chest X-ray had a great role in confirming the disease or its complications. There has been a recommendation to perform daily CRX for patients with severe cardiopulmonary disease or receiving mechanical ventilation, as well as immediate CXR imaging for all patients who have had endotracheal tubes, feeding tubes, vascular catheters, and chest tubes. The most effective principle of radiation protection is distance, when performing an X-ray, the technologist must be at least six feet (1.5 to 2 m) from the radiation source. If the technician needs to be close to the radiation source, wearable lead shields and thyroid collars can protect the radiation-sensitive areas of the body. Conclusion: The chest X-ray of ICU patients was an important diagnostic tool that would affect patient management; however, it may also be a tool that can lead to serious complications for patient. A small sample size was used in this investigation that results in unconfirmed information, the future research using a large sample size is needed to carry out a more reliable and valid information.

scholarly journals Neonatal Necrotizing Enterocolitis

2011 ◽  
Vol 11 ◽  
pp. 655-656
Author(s):  
Saad Lahmiti ◽  
Abdelmounaim Aboussad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
Gastrointestinal Disease ◽  
Gastrointestinal Disorder ◽  
X Ray ◽  
Infection And Inflammation ◽  
Neonatal Necrotizing Enterocolitis

Necrotizing enterocolitis (NEC) is a gastrointestinal disease that mostly affects premature infants. It involves infection and inflammation that causes destruction of the bowel. Although it affects only 1 in 2,000 to 4,000 births, or between 1 and 5% of neonatal intensive care unit admissions, NEC is the most common and serious gastrointestinal disorder among hospitalized preterm infants. We present a very representative abdominal X-ray of this disease.

Problems in Thin-Film X-ray Quantification

1990 ◽  
Vol 48 (2) ◽  
pp. 458-459
Author(s):  
J N Chapman ◽  
W A P Nicholson
Keyword(s):  
Thin Film ◽  
Specimen Thickness ◽  
X Rays ◽  
Characteristic Peak ◽  
Local Composition ◽  
X Ray ◽  
Measured Ratio ◽  
Path Lengths ◽  
Composition Changes

Energy dispersive x-ray microanalysis (EDX) is widely used for the quantitative determination of local composition in thin film specimens. Extraction of quantitative data is usually accomplished by relating the ratio of the number of atoms of two species A and B in the volume excited by the electron beam (nA/nB) to the corresponding ratio of detected characteristic photons (NA/NB) through the use of a k-factor. This leads to an expression of the form nA/nB = kAB NA/NB where kAB is a measure of the relative efficiency with which x-rays are generated and detected from the two species.Errors in thin film x-ray quantification can arise from uncertainties in both NA/NB and kAB. In addition to the inevitable statistical errors, particularly severe problems arise in accurately determining the former if (i) mass loss occurs during spectrum acquisition so that the composition changes as irradiation proceeds, (ii) the characteristic peak from one of the minority components of interest is overlapped by the much larger peak from a majority component, (iii) the measured ratio varies significantly with specimen thickness as a result of electron channeling, or (iv) varying absorption corrections are required due to photons generated at different points having to traverse different path lengths through specimens of irregular and unknown topography on their way to the detector.

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