Skip to main content

Tip Navigation and Tip Location Methods

  • Chapter
  • First Online:
Vascular Access in Neonates and Children

Abstract

The insertion of a central venous access is complex procedure that includes several phases: recognition of the need for a central line, ultrasound evaluation of the possible options in terms of venipuncture and location of the exit site, cannulation of the vein, intraprocedural ruling out of possible puncture-related complication, assessment of the proper direction of the catheter inside the vasculature, intraprocedural assessment of the final location of the tip of the catheter in a ‘central’ position, securement of the catheter and protection of the exit site.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Bibliography

  1. Barone G, Pittiruti M, Ancora G, Vento G, Tota F, D’Andrea V. Centrally inserted central catheters in preterm neonates with weight below 1500 g by ultrasound-guided access to the brachio-cephalic vein. J Vasc Access 2021a May;22(3):344–352. https://doi.org/10.1177/1129729820940174. Epub 2020 Jul 10.

  2. Barone G, Pittiruti M, Biasucci DG, Elisei D, Iacobone E, La Greca A, Zito Marinosci G, D’Andrea V. Neo-ECHOTIP: a structured protocol for ultrasound-based tip navigation and tip location during placement of central venous access devices in neonates. J Vasc Access 2021b Apr 5:11297298211007703. https://doi.org/10.1177/11297298211007703. Epub ahead of print. PMID: 33818191.

  3. Capasso A, Mastroianni R, Passariello A, Palma M, Messina F, Ansalone A, Bernardo I, Brescia D, Crispino F, Grassia C, Romano A, Ausanio G. The intracavitary electrocardiography method for positioning the tip of epicutaneous cava catheter in neonates: pilot study. J Vasc Access 2018 Nov;19(6):542–547. https://doi.org/10.1177/1129729818761292. Epub 2018 Mar 18. PMID: 29552936.

  4. Cellini M, Bergadano A, Crocoli A, Badino C, Carraro F, Sidro L, Botta D, Pancaldi A, Rossetti F, Pitta F, Cesaro S. Guidelines of the Italian Association of Pediatric Hematology and Oncology for the management of the central venous access devices in pediatric patients with onco-hematological disease. J Vasc Access 2020 Nov 10:1129729820969309. https://doi.org/10.1177/1129729820969309. Epub ahead of print. PMID: 33169648.

  5. Crocoli A, Tornesello A, Pittiruti M, Barone A, Muggeo P, Inserra A, Molinari AC, Grillenzoni V, Durante V, Cicalese MP, Zanazzo GA, Cesaro S. Central venous access devices in pediatric malignancies: a position paper of Italian Association of Pediatric Hematology and Oncology. J Vasc Access 2015 Mar-Apr;16(2):130–136. https://doi.org/10.5301/jva.5000314. Epub 2014 Oct 14. PMID: 25362978.

  6. Iacobone E, Elisei D, Gattari D, Carbone L, Capozzoli G. Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia. J Vasc Access 2020 Nov;21(6):861–867. https://doi.org/10.1177/1129729820905200. Epub 2020 Mar 4. PMID: 32126882.

  7. Lamperti M, Biasucci DG, Disma N, Pittiruti M, Breschan C, Vailati D, Subert M, Traškaitė V, Macas A, Estebe JP, Fuzier R, Boselli E, Hopkins P. European Society of Anaesthesiology guidelines on peri-operative use of ultrasound-guided for vascular access (PERSEUS vascular access). Eur J Anaesthesiol. 2020 May;37(5):344–376. https://doi.org/10.1097/EJA.0000000000001180. Erratum in: Eur J Anaesthesiol. 2020 Jul;37(7):623. PMID: 32265391.

  8. Mastroianni R, Capasso A, Ausanio G. The intracavitary electrocardiography method for tip location of jugular internal vein access device in infants of less than 5 kg: a pilot study. J Vasc Access 2018 Nov;19(6):639–643. https://doi.org/10.1177/1129729818769028. Epub 2018 Apr 13. PMID: 29651905.

  9. Pittiruti M, Pelagatti F, Pinelli F. Intracavitary electrocardiography for tip location during central venous catheterization: a narrative review of 70 years of clinical studies. J Vasc Access 2020 Jun 24:1129729820929835. https://doi.org/10.1177/1129729820929835. Epub ahead of print. PMID: 32578489.

  10. Raffaele A, Segal A, Romano P, Vatta F, Boghen S, Bonetti F, Parigi GB, Avolio L. Intracavitary electrocardiography-guided positioning of central vascular access device can spare unnecessary ionizing radiation exposure in pediatric patients. J Vasc Access 2021 Jan;22(1):64–68. https://doi.org/10.1177/1129729820923936. Epub 2020 May 26. PMID: 32452241.

  11. Rossetti F, Pittiruti M, Lamperti M, Graziano U, Celentano D, Capozzoli G. The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study. J Vasc Access 2015 Mar-Apr;16(2):137–143. https://doi.org/10.5301/jva.5000281. Epub 2014 Sep 2. PMID: 25198817.

  12. Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J, Sanchez-de-Toledo J, Brierley J, Colunga JM, Raffaj D, Da Cruz E, Durand P, Kenderessy P, Lang HJ, Nishisaki A, Kneyber MC, Tissieres P, Conlon TW, De Luca D. International evidence-based guidelines on point of care ultrasound (POCUS) for critically ill neonates and children issued by the POCUS working Group of the European Society of paediatric and neonatal intensive care (ESPNIC). Crit Care 2020;24(1):65. https://doi.org/10.1186/s13054-020-2787-9. PMID: 32093763; PMCID: PMC7041196.

  13. Spagnuolo F, Vacchiano T. Ultrasound-guided cannulation of the brachiocephalic vein in newborns: a novel approach with a supraclavicular view for tip navigation and tip location. J Vasc Access 2021 Mar 16:11297298211001159. https://doi.org/10.1177/11297298211001159. Epub ahead of print. PMID: 33726580.

  14. Weber MD, Himebauch AS, Conlon T. Use of intracavitary-ECG for tip location of femorally inserted central catheters. J Vasc Access 2020 Dec 25:1129729820982864. https://doi.org/10.1177/1129729820982864. Epub ahead of print. PMID: 33356809.

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pittiruti, M. (2022). Tip Navigation and Tip Location Methods. In: Biasucci, D.G., Disma, N.M., Pittiruti, M. (eds) Vascular Access in Neonates and Children. Springer, Cham. https://doi.org/10.1007/978-3-030-94709-5_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-94709-5_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-94708-8

  • Online ISBN: 978-3-030-94709-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics