Vascular access in neonates and small infants is often a difficult and critical procedure, requiring precision to avoid complications. Ultrasound (US) has emerged as a key tool in improving the safety and efficacy of these procedures. This systematic review highlights the advantages of using ultrasound for pre-implantation evaluations, enabling clear imaging of vessels, the surrounding anatomy, and potential anatomical variations. The technique is non-invasive, radiation-free, and provides both static and dynamic views, crucial for ensuring safe catheter insertion. Ultrasound aids in identifying vessel caliber and depth, and evaluates vessel patency while helping detect potential complications like thrombosis.
In neonatal care, obtaining central venous access can be especially challenging due to the small size of vascular structures. Traditional landmark-based techniques are often limited by anatomical variations, leading to a higher rate of complications such as arterial puncture or failed attempts. Studies suggest that ultrasound-guided catheter insertion is safer, more effective, and has a reduced complication rate compared to blind insertion methods. Furthermore, real-time ultrasound allows for better visualization of the target vessels, reducing the need for multiple venipuncture attempts. The review also emphasizes the importance of training for healthcare providers in the use of ultrasound, as accurate interpretation and coordination are key to avoiding errors during insertion. Although the use of ultrasound has proven beneficial, it is not without challenges, including the need for specialized equipment and trained personnel. However, its integration into clinical practice, particularly in neonatal intensive care units (NICUs), could significantly improve patient outcomes.
