Positioning long lines: contrast versus plain radiography

Aim-To assess the value of contrast versus plain radiography in determining radio-opaque long line tip position in neonates. Methods-In a prospective study, plain radiography was performed after inser tion of radio-opaque long lines. If the line tip was not visible on the pla in film, a second film with contrast was obtained in an attempt to visualis e the tip. Results-Sixty eight lines were inserted during the study period, 62 of whic h were included in the study. In 31, a second radiographic examination with contrast was necessary to determine position of the tip. In 29 of these, t he line tip was clearly visualised with contrast. On two occasions, the lin e tip could not be seen because the contrast had filled the vein and obscur ed the tip from view. Eight of the lines that required a second radiograph with contrast were repositioned. Conclusion-Intravenous contrast should be routinely used in the assessment of long line position in the neonate.