Rates of Intracardiac Umbilical Venous Catheter Placement in Neonates
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Bibliographic record
Abstract
OBJECTIVES: To review umbilical venous catheter (UVC) placement in neonates who underwent targeted neonatal echocardiography (TNE) and to correlate catheter tip placement on TNE and anteroposterior thoracoabdominal radiography. METHODS: We conducted a retrospective analysis of 51 neonates who had UVC positions assessed by TNE and radiography in a neonatal intensive care unit (NICU). A single operator performed all TNE examinations. The final radiographic catheter placement was taken from the image closest to the time of echocardiography. Fisher exact, χ(2), and t tests were used as appropriate. RESULTS: Among the 51 neonates who had catheters placed for 24 hours or more, TNE was performed on 48 in the first 48 hours, 2 at day 6, and 1 at day 9. Thirty-six neonates were extremely low birth weight (ELBW; <1000 g). Twenty-nine had good catheter tip positions, and 22 had catheters inside the heart (10 in the right atrium [RA], 3 at the foramen ovale, and 9 in the left atrium [LA]). Twenty neonates with catheter tips in the heart were ELBW, including 8 with catheters in the LA. The ELBW neonates were more likely to have catheters in the heart than non-ELBW neonates (20 of 36 versus 2 of 15; P= .01; odds ratio [OR], 8.1; confidence interval [CI], 1.59-41.3). Good placement on TNE varied widely in relation to thoracic vertebral landmarks on radiography: from the T7-8 interspace to T11. When radiography showed a catheter tip at T9-T10, there was no difference in the proportion of neonates with a good catheter position versus malposition (8 of 22 versus 8 of 29; P = .55; OR, 0.67; CI, 0.20-2.19). CONCLUSIONS: A high proportion of ELBW neonates in a busy NICU had UVCs placed with the tips in the RA or LA despite common placement practices. We recommend adding TNE to radiography to position UVCs, especially in ELBW neonates.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it