Ultrasound plays a critical role in enhancing the safety and precision of vascular access in newborns, offering benefits from pre-procedural planning through to complication management. Its applications include selecting appropriate veins before the procedure, guiding real-time venipuncture, verifying guidewire or catheter progression, and confirming catheter tip location post-procedure. Additionally, ultrasound facilitates the early detection of complications such as hematoma, pneumothorax, and hemothorax, as well as later-stage issues including cardiac tamponade, fibroblastic sleeve formation, and thrombosis. This study emphasizes the Rapid Central Vein Assessment (Ra.Ce.VA), a systematic and standardized ultrasound protocol, specifically adapted for neonates to ensure comprehensive and consistent evaluation across all stages of vascular access.
Key techniques and devices include the central venous catheter (CVC), centrally inserted central catheter (CICC), and femoral inserted central catheter (FICC). Each insertion site, whether at the internal jugular vein (IJV) or other vascular entry points, benefits from ultrasound guidance to ensure accuracy and minimize risks. Ultrasound, particularly transthoracic echocardiography (TTE) and contrast-enhanced ultrasound (CEUS), is also instrumental in identifying the cavoatrial junction (CAJ) to confirm optimal catheter placement. For neonatal intensive care units (NICUs), where neonates’ vascular access can be complex, standardized ultrasound protocols such as Ra.Ce.VA enhance procedural success rates and reduce the likelihood of adverse events, leading to improved outcomes in fragile newborns. As a result, ultrasound-guided vascular access is increasingly integral to neonatal care protocols worldwide, underscoring its value in both preventing and managing complications.
