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Routine X-Ray Not Needed After US-Guided Central Line Insertion


Routine X-Ray Not Needed After US-Guided Central Line Insertion

Pneumothorax and catheter misplacement after ultrasound-guided central venous catheter (CVC)  insertion were rare, and the costs of a postprocedural chest X-ray (CXR) were exceedingly high, according to a study published in the CHEST journal. The study suggested that a routine postprocedural CXR is unnecessary and not a wise choice.

A routine chest radiograph (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. Jason Chui and his associates conducted a study to assess the value of a routine postprocedural CXR in the era of ultrasound-guided CVC insertion.

The investigators performed a population-based retrospective cohort study to review the records of all adult patients who had a CVC inserted in the operating room and determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion. The researchers then examined the potential risk factors associated with these complications and analyzed the cost to evaluate the economic impact. A total of 6,875 patients were included in the study.

Key study findings:

  • The overall incidence of pneumothorax and catheter misplacement was 0.33% and 1.91% respectively.
  • The site of catheterization was the major determinant of pneumothorax and catheter misplacement; left subclavian vein catheterization was the site at a higher risk for pneumothorax.
  • Catheterization sites other than the right internal jugular vein were at a higher risk for catheter misplacement. Expenditures on routine postprocedural CXR were the US $105,000 to $183,000 per year.

According to the authors, a routine post-procedural CXR is unnecessary and not a wise choice.

For reference log on to  https://doi.org/10.1016/j.chest.2018.02.017

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Vinay Singh

Vinay Singh

Vinay Singh joined Medical Dialogue as Desk Editor in 2018. He covers the medical speciality news in different medical categories including Medical guidelines, updates from Medical Journals and Case Reports. He completed his graduation in Biotechnology from AAIDU and did his MBA from IILM Gurgaon. He can be contacted at editorial@medicaldialogues.in . Contact no. 011-43720751
Source: with inputs from the CHEST Journal

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  1. Population studied, clinical setting, hospital set up make a huge difference in outcome. This study was performed in a tertiary healthcare centre with CVC line placements done in OR under US guidance in adult patients. Their population had a lower chances of line insertion related complications,
    Please share if you have a reference of multicentre study including all age groups.