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Long lines and atypical anatomy
  1. Katherine J Pettinger1,
  2. Alexander I C Wordie1,
  3. Chris J Vas1,
  4. Louise Hattingh2,
  5. Chakrapani Vasudevan1
  1. 1 Neonatal Unit, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
  2. 2 Department of Radiology, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
  1. Correspondence to Dr Katherine J Pettinger, Neonatal Unit, Bradford Teaching HospitalsFoundation Trust, Duckworth Lane, Bradford BD9 6RJ, UK; katherinepettinger{at}gmail.com

https://doi.org/10.1136/archdischild-2018-316612

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    A 780 g twin was born at 26 weeks gestation. Following surfactant, oxygen saturations were maintained with continuous positive airway pressure. Umbilical lines were inserted. Five days later, a 1 French long line was peripherally inserted, for ongoing parenteral nutrition.

    1. Name items a–e on figure 1. Are their positions acceptable?

    2. How might arterial and venous lines be differentiated?

      1. Blood gas.

      2. Colour/flow of blood on cannulation.

      3. Flow of contrast from the line tip.

      4. Radiograph.

    3. Which of these are possible diagnoses?

      1. Dextrocardia.

      2. Dextrocardia situs inversus totalis.

      3. Tetralogy of Fallot.

      4. Dextroposition.

    Answers can be found on page 02.

    ANSWERS TO THE QUESTIONS ON PAGE 01

    1. Name items a–e on figure 1. Are their positions acceptable?

      1. Peripherally inserted long line: uncertain position. A left-sided long line should cross the midline to enter the superior vena cava (SVC).

      2.  Umbilical arterial catheter (UAC): acceptable position. UACs lie on the left side of the …

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    Footnotes

    • Contributors KP and AW wrote the body of the article, with contributions and editing from CV, LH and CV.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Parental/guardian consent obtained.