Journal article
Is immediate chest radiograph necessary after central venous catheter placement in a surgical intensive care unit?
The American journal of surgery, v 180(6), pp 517-522
01 Dec 2000
PMID: 11182410
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Current standard of care dictates that central venous catheter (CVC) insertion should be followed by an immediate chest radiograph to confirm appropriate position and rule out complications. We hypothesized that a subset of monitored intensive care unit patients exists that is at low risk for complications and might safely have radiographic evaluation of line placement deferred until the next scheduled radiograph.
Methods: Data regarding patient and procedural characteristics were obtained prospectively for 184 CVC placed between March 1, 1998, and June 30, 1999. Retrospective data regarding complications were obtained by chart review for an additional 174 CVC placed during the study period but for which data sheets were not completed. All procedures were followed by chest radiography.
Results: We documented a complication rate of 9% with the vast majority (25 of 31, 81%) of complications consisting of incorrect positioning. The number of needle passes was greater in the group suffering pneumothorax and arterial puncture than the uncomplicated group (5.6 versus 1.9,
P = 0.008). “Straightforward” operator gestalt (
P = 0.04) and number of needle passes <3 (
P = 0.03) were factors correlating with the absence of complications. These factors had negative predictive values of 94% and 96%, respectively.
Conclusions: Placement of CVC is safe in experienced hands. In monitored intensive care unit patients who undergo a “straightforward” procedure with <3 needle passes, chest radiograph can be safely deferred until the next scheduled examination.
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Details
- Title
- Is immediate chest radiograph necessary after central venous catheter placement in a surgical intensive care unit?
- Creators
- Stephen H Bailey - University of UtahStephen B Shapiro - University of UtahMary C Mone - University of UtahJeffrey R Saffle - University of UtahStephen E Morris - University of UtahRichard G Barton - University of Utah
- Publication Details
- The American journal of surgery, v 180(6), pp 517-522
- Publisher
- Elsevier
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiothoracic Surgery
- Web of Science ID
- WOS:000167021600067
- Scopus ID
- 2-s2.0-0034469576
- Other Identifier
- 991021960813704721
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InCites Highlights
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- Web of Science research areas
- Surgery