Anatomical landmarks on radiography for peripheral central catheter in newborns: integrative review

Objective: To summarize the scientific evidence on anatomical landmarks on radiography used to evaluate the distal tip of the peripherally inserted central catheter in newborns. Methods: This is an integrative literature review performed between 2017 and 2021 in Web of Science, National Library of Medicine (PubMed/MEDLINE) and Scopus databases. Results: Thirteen out of 263 documents found in the databases met the eligibility criteria and were selected for analysis. Of these, 12 were observational studies and one was experimental. As for the country of origin, only one study was published in Brazil, five in China, two in the United States of America; and Italy, Germany, Canada, Iran and India with one study each. The evidence found demonstrated the existence of seven anatomical landmarks used in radiography to visualize the tip of the percutaneous catheter in newborns, and the vertebral body as the predominant guiding reference. Conclusion: For catheters inserted in the upper limbs, the anatomical landmarks closer to the cavo-atrial junction are the fifth and seventh thoracic vertebrae, or two vertebral bodies below the level of the carina. For the lower limbs, the catheter tip should be positioned between the ninth and tenth thoracic vertebrae or above the fourth lumbar vertebra.