Percutaneous long lines (LL) are routinely used in preterm babies for providing parenteral nutrition (PN). Malpositioning of LL tips is associated with serious complications.1–5 No national guidelines exist outlining the best imaging techniques to establish LL position.Aim
To determine how tertiary neonatal intensive care units (previously Level 3 Neonatal Units) across the UK ascertain LL position.Method
All fifty-two tertiary neonatal intensive care units in the UK were contacted. It was established whether they followed local/regional guidelines regarding insertion and imaging of LL. Information was collected on imaging modalities used to establish LL tip position and procedure following LL adjustment.Results
40/52 units have guidelines on LL insertion and post-insertion imaging. 26/52 units used plain X-ray alone and 9/52 units used X-ray with contrast, the rest used a combination of both to ascertain LL position. 10 units used contrast when Premicaths® were inserted. Following line adjustment, 21 units did not routinely perform a repeat X-ray. 17 units used plain X-ray, 5 units utilised X-ray with contrast and 9 units used a combination of X-ray with contrast and/or plain X-ray depending on the LL type and position.Conclusions
Variation in practice across the UK exists regarding LL position. Some of these differing practices likely pertain to the perceived best imaging technique of the various LL available on the market. Further research into the best imaging techniques for each available LL is warranted to determine national guidelines, which would aid in reducing complications from LL insertion.