Neonatal Chest with Normally Positioned Tubes and Lines

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Etiology/Pathophysiology:
Not Applicable

Pathology:
Not Applicable

Imaging Findings:
The position of the tubes and lines on a neonatal chest x-ray should be as follows:

Endotracheal tube (ETT) tip: beneath the thoracic inlet and above the carina

Nasogastric tube (NGT) tip: within the stomach

Feeding tube (FT) tip: within the third portion of the duodenum

Central venous line tip placed from subclavian/jugular/antecubital approaches should be within the superior vena cava (SVC)

Central venous line tips placed from a femoral approach should be low in the inferior vena cava (IVC) [below L3] or at the junction of the inferior vena cava and right atrium (RA)

Umbilical artery catheter (UAC) tip: can be either high [between T7 and T11] or low [below L3]. On the lateral film the UAC dips into the pelvis from the umbilicus through one of the paired umbilical arteries and then courses through the internal iliac artery and then into the common iliac artery and aorta. The UAC generally projects over the left side of the spine on the AP film.

Umbilical venous catheter (UVC) tip: at the junction of the right atrium (RA) and the superior vena cava (SVC). On the lateral film the UVC extends cephalad from the umbilicus through the umbilical vein and then courses into the portal vein, across the ductus venosus, and into the inferior vena cava. The UVC generally projects over the right side of the spine on the supine x-ray.

DDX:
Not applicable

References:
See References Chapter.

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