Routine chest X-ray is not required after a low-risk central venous cannulation.
(2009) In Acta Anaesthesiologica Scandinavica 53. p.1145-1152- Abstract
- Background: Knowledge of the radiographic catheter tip position after central venous cannulation is normally not required for short-term catheter use. Detection of a possible iatrogenic pneumothorax may nevertheless justify routine post-procedure chest X-ray. Our aim was to design a clinical decision rule to select patients for radiographic evaluation after central venous cannulation. Methods: A total of 2230 catheterizations performed using external jugular, internal jugular or subclavian venous approaches during a 4-year period were included consecutively. Information on patient data and corresponding procedures was recorded prospectively. A post-procedure chest X-ray was obtained after each cannulation. Results: Thirteen cases (0.58%)... (More)
- Background: Knowledge of the radiographic catheter tip position after central venous cannulation is normally not required for short-term catheter use. Detection of a possible iatrogenic pneumothorax may nevertheless justify routine post-procedure chest X-ray. Our aim was to design a clinical decision rule to select patients for radiographic evaluation after central venous cannulation. Methods: A total of 2230 catheterizations performed using external jugular, internal jugular or subclavian venous approaches during a 4-year period were included consecutively. Information on patient data and corresponding procedures was recorded prospectively. A post-procedure chest X-ray was obtained after each cannulation. Results: Thirteen cases (0.58%) of cannulation-associated pneumothorax were identified. The risk of pneumothorax after a technically difficult (1.8%) or subclavian (1.6%) cannulation was significantly higher than after cannulation not considered as difficult (0.37%) or performed using other routes (0.33%). Clinical signs of pneumothorax within 8 h of cannulation were found in all seven patients with pneumothorax requiring specific treatment. A new clinical decision rule for radiographic evaluation after central venous cannulation based on the results of the present study shows that 48% of the post-procedure chest X-rays performed in our patients were clinically redundant. Conclusion: Clinical symptoms were reported in all patients with pneumothorax requiring specific treatment. Approximately half of the post-procedure chest X-ray controls could be avoided using the proposed clinical decision rule to select patients for radiographic evaluation after central venous cannulation. A large prospective multi-centre study should be carried out to further evaluate this decision rule. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1412577
- author
- Pikwer, Andreas LU ; Bååth, Lars LU ; Perstoft, I ; Davidson, B and Åkeson, Jonas LU
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Anaesthesiologica Scandinavica
- volume
- 53
- pages
- 1145 - 1152
- publisher
- Wiley-Blackwell
- external identifiers
-
- wos:000269537100006
- pmid:19422354
- scopus:69949161480
- ISSN
- 0001-5172
- DOI
- 10.1111/j.1399-6576.2009.01980.x
- language
- English
- LU publication?
- yes
- id
- da4aebb7-19cd-4cc6-9393-cd44d03c8bd5 (old id 1412577)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19422354?dopt=Abstract
- date added to LUP
- 2016-04-04 08:54:52
- date last changed
- 2022-01-29 07:39:36
@article{da4aebb7-19cd-4cc6-9393-cd44d03c8bd5,
abstract = {{Background: Knowledge of the radiographic catheter tip position after central venous cannulation is normally not required for short-term catheter use. Detection of a possible iatrogenic pneumothorax may nevertheless justify routine post-procedure chest X-ray. Our aim was to design a clinical decision rule to select patients for radiographic evaluation after central venous cannulation. Methods: A total of 2230 catheterizations performed using external jugular, internal jugular or subclavian venous approaches during a 4-year period were included consecutively. Information on patient data and corresponding procedures was recorded prospectively. A post-procedure chest X-ray was obtained after each cannulation. Results: Thirteen cases (0.58%) of cannulation-associated pneumothorax were identified. The risk of pneumothorax after a technically difficult (1.8%) or subclavian (1.6%) cannulation was significantly higher than after cannulation not considered as difficult (0.37%) or performed using other routes (0.33%). Clinical signs of pneumothorax within 8 h of cannulation were found in all seven patients with pneumothorax requiring specific treatment. A new clinical decision rule for radiographic evaluation after central venous cannulation based on the results of the present study shows that 48% of the post-procedure chest X-rays performed in our patients were clinically redundant. Conclusion: Clinical symptoms were reported in all patients with pneumothorax requiring specific treatment. Approximately half of the post-procedure chest X-ray controls could be avoided using the proposed clinical decision rule to select patients for radiographic evaluation after central venous cannulation. A large prospective multi-centre study should be carried out to further evaluate this decision rule.}},
author = {{Pikwer, Andreas and Bååth, Lars and Perstoft, I and Davidson, B and Åkeson, Jonas}},
issn = {{0001-5172}},
language = {{eng}},
pages = {{1145--1152}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Anaesthesiologica Scandinavica}},
title = {{Routine chest X-ray is not required after a low-risk central venous cannulation.}},
url = {{http://dx.doi.org/10.1111/j.1399-6576.2009.01980.x}},
doi = {{10.1111/j.1399-6576.2009.01980.x}},
volume = {{53}},
year = {{2009}},
}