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Title: Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?

Abstract

Purpose: To study the cost and impact on patient management of the routine performance of chest radiographs in patients undergoing imaged-guided central venous catheter insertion. Methods: Six hundred and twenty-one catheters placed in 489 patients over a 42-month period formed the study group. Catheters were placed in the right internal jugular vein (425), left internal jugular vein (133), and subclavian veins (63). At the end of the procedure fluoroscopy was used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. Results: Postprocedural chest fluoroscopy showed no evidence of pneumothorax, hemothorax, or mediastinal hematoma. Inappropriate catheter tip position or catheter kinks were noted with 90 catheters. These problems were all corrected while the patient was on the interventional table. Postprocedural chest radiographs showed no complications but proximal catheter tip migration was noted in six of 621 catheters (1%). These latter six catheters required further manipulation. The total technical and related charges for the postprocedural chest radiographs in this series were estimated at Pounds 15,525. Conclusion: Postprocedural chest radiographs after image-guided central venous catheter insertion are not routinely required. A postprocedural chest radiograph can be performed on a case-by-case basis at the discretion ofmore » the interventional radiologist.« less

Authors:
; ; ;  [1]
  1. Department of Radiology, Beaumont Hospital and Royal College of Surgeons in Ireland Medical School, Beaumont Road, Dublin 9 (Ireland)
Publication Date:
OSTI Identifier:
21080277
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 22; Journal Issue: 5; Other Information: DOI: 10.1007/s002709900411; Copyright (c) 1999 Springer-Verlag New York Inc; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEST; COST; EVALUATION; FLUOROSCOPY; HEMATOMAS; IMAGES; PATIENTS; VEINS

Citation Formats

Lucey, Brian, Varghese, Jose C., Haslam, Philip, and Lee, Michael J. Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?. United States: N. p., 1999. Web. doi:10.1007/S002709900411.
Lucey, Brian, Varghese, Jose C., Haslam, Philip, & Lee, Michael J. Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?. United States. doi:10.1007/S002709900411.
Lucey, Brian, Varghese, Jose C., Haslam, Philip, and Lee, Michael J. Wed . "Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?". United States. doi:10.1007/S002709900411.
@article{osti_21080277,
title = {Routine Chest Radiographs After Central Line Insertion: Mandatory Postprocedural Evaluation or Unnecessary Waste of Resources?},
author = {Lucey, Brian and Varghese, Jose C. and Haslam, Philip and Lee, Michael J.},
abstractNote = {Purpose: To study the cost and impact on patient management of the routine performance of chest radiographs in patients undergoing imaged-guided central venous catheter insertion. Methods: Six hundred and twenty-one catheters placed in 489 patients over a 42-month period formed the study group. Catheters were placed in the right internal jugular vein (425), left internal jugular vein (133), and subclavian veins (63). At the end of the procedure fluoroscopy was used to assess catheter position and check for complications. A postprocedural chest radiograph was obtained in all patients. Results: Postprocedural chest fluoroscopy showed no evidence of pneumothorax, hemothorax, or mediastinal hematoma. Inappropriate catheter tip position or catheter kinks were noted with 90 catheters. These problems were all corrected while the patient was on the interventional table. Postprocedural chest radiographs showed no complications but proximal catheter tip migration was noted in six of 621 catheters (1%). These latter six catheters required further manipulation. The total technical and related charges for the postprocedural chest radiographs in this series were estimated at Pounds 15,525. Conclusion: Postprocedural chest radiographs after image-guided central venous catheter insertion are not routinely required. A postprocedural chest radiograph can be performed on a case-by-case basis at the discretion of the interventional radiologist.},
doi = {10.1007/S002709900411},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 5,
volume = 22,
place = {United States},
year = {1999},
month = {9}
}