Visualizing an Umbilical Venous Catheter in Malposition Using POCUS

Umbilical venous catheters (UVCs) are commonly needed in critically ill infants in the neonatal intensive care unit (NICU). However, there is an increased risk for major adverse events with improper positioning. There is a strong argument for using point of care ultrasound (POCUS) to determine catheter tip positioning during and after UVC placement, but X-rays remain the gold standard in many NICUs. This case reports a UVC in malposition in the liver viewed on POCUS after appearing to be in the correct position on both anteroposterior (AP) and lateral X-rays.