Ultrasound-guided catheter tip location in neonatal central venous access. Focus on well-defined protocols and proper ultrasound training

the high success rate in tip location. This is probably secondary to the appropriate training of the health care providers in the use of ultrasound scans and to the adoption of a well-defined protocol for tip location. We have previously proposed a very similar approach,2 developing a protocol, “Neo-ECHOTIP,” which includes the use of 3 different acoustic windows (apical 4-chamber view, bicaval subcostal view, high right parasternal longitudinal view) plus a small flush of normal saline (so-called “bubble test”), so to increase the accuracy of tip visualization.