Where should uac be on x ray?

Umbilical Venous Catheter in Left Ventricle

For more on Umbilical Venous and Arterial Catheters, including their normal positioning, uses and examples of aberrant positioning, click on this link

Normal Positioning

Umbilical Venous Catheter (UVC) at T9. There is an UVC that ascends slightly to the right and over the spine (white arrows) to the level of T9 (yellow arrow). The umbilical arterial catheter (UAC) is at L4 (red arrow).

From Auckland District Health Board

Umbilical Venous Catheter (UVC) in region of Left Ventricle. An umbilical venous catheter ascends to the right of the spine (red arrow). It continue into the inferior vena cava and right atrium (white arrow). It then passes through a patent foramen ovale into the left side of the heart (yellow arrow) and finally into the left ventricle (green arrow).

Please note: images that have a white symbol at the top right, such as the UAC in the high position image below, indicates an image gallery that has multiple images - click on the image to open the gallery.

In the first two images the UAC is at T6, which is satisfactory. The UVC is at T7. Ideally, both should be above the diaphragm. The UAC should be between T6 and T9¹. The UVC should be in the IVC as it enters the right atrium.

The third and fourth images show the UAC clearly in too high, sitting just below the left subclavian artery.

Not surprisingly, it was not reading the blood pressure too well, nor sampling well.

A UAC should lie within the aorta, avoiding the location of any major branches, having taken a course through either of the umbilical arteries into the left or right internal iliac artery, iliac artery and into the aorta (see Figure 1).