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Vito D’Andrea, Giorgia Prontera, Serena Antonia Rubortone, Lucilla Pezza, Giovanni Pinna, Giovanni Barone, Mauro Pittiruti and Giovanni Vento. Umbilical Venous Catheter Update: A Narrative Review Including Ultrasound and Training. Frontiers in Pediatrics. 2022 Jan.

The umbilical venous catheter (UVC) is one of the most commonly used central lines in neonates. It can be  easily inserted soon after birth providing stable intravenous access in infants requiring advanced

resuscitation in the delivery room or needing medications, fluids, and parenteral nutrition during the 1st days  of life. Resident training is crucial for UVC placement. The use of simulators allows trainees to gain practical  experience and confidence in performing the procedure without risks for patients. UVCs are easy to insert, however when the procedure is performed without the use of ultrasound, there is a quite high risk, up to 40%, of non-central position. Ultrasound-guided UVC tip location is a simple and learnable technique and
therefore should be widespread among all physicians. The feasibility of targeted training on the use of point- of-care ultrasound (POCUS) for UVC placement in the neonatal intensive care unit (NICU) among neonatal  medical staff has been demonstrated. Conversely, UVC-related complications are very common and can sometimes be life-threatening. Despite UVCs being used by neonatologists for over 60 years, there are still  no standard guidelines for assessment or monitoring of tip location, securement, management, or dwell time.  This review article is an overview of the current knowledge and evidence available in the literature about UVCs. Our aim is to provide precise and updated recommendations on the use of this central line.

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