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Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip

BACKGROUND: Proper placement of central venous catheter (CVC) tip could reduce early and late catheter-related complications. Although the live fluoroscopy is standard of care for placement of the catheter, it is not available in many centers. Therefore, the present study evaluated the sensitivity a...

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Autores principales: Salimi, Fereshteh, Hekmatnia, Ali, Shahabi, Javad, Keshavarzian, Amir, Maracy, Mohammad Reza, Jazi, Amir Hosein Davarpanah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354071/
https://www.ncbi.nlm.nih.gov/pubmed/25767527
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author Salimi, Fereshteh
Hekmatnia, Ali
Shahabi, Javad
Keshavarzian, Amir
Maracy, Mohammad Reza
Jazi, Amir Hosein Davarpanah
author_facet Salimi, Fereshteh
Hekmatnia, Ali
Shahabi, Javad
Keshavarzian, Amir
Maracy, Mohammad Reza
Jazi, Amir Hosein Davarpanah
author_sort Salimi, Fereshteh
collection PubMed
description BACKGROUND: Proper placement of central venous catheter (CVC) tip could reduce early and late catheter-related complications. Although the live fluoroscopy is standard of care for placement of the catheter, it is not available in many centers. Therefore, the present study evaluated the sensitivity and specificity of bedside chest X-ray (CXR) for proper positioning of the catheter tip. MATERIALS AND METHODS: A total of 82 adult patients undergoing elective placement of tunneled CVC were enrolled in this study during 2010-2012. The catheter tip position was evaluated by postoperative bedside chest radiographs as well as trans-thoracic echocardiogram as definite diagnostic tool. The catheter position was considered correct if the tip was positioned in the right atrium both in CXR or echocardiography. Finally, CXRs interpreted by expert radiologist. Thus findings were compared by echocardiography. Sensitivity, specificity, accuracy, positive, and negative predictive values were calculated. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL), and P < 0.05 considered as significant. RESULTS: The patients were 57.37 ± 18.91 years of age, weighed 65.79 ± 15.58 kg and were 166.36 ± 9.91 cm tall. Sensitivity and specificity of CXR for proper catheter tip position were 74.3% and 58.3%, respectively. Positive and negative predictive values were 91.2% and 28%. In addition accuracy, positive likelihood ratio, and negative likelihood ratio were 71.9%, 1.78, and 2.27 respectively. CONCLUSION: Bedside CXR alone does not reliably predict malpositioning after CVC placement.
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spelling pubmed-43540712015-03-12 Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip Salimi, Fereshteh Hekmatnia, Ali Shahabi, Javad Keshavarzian, Amir Maracy, Mohammad Reza Jazi, Amir Hosein Davarpanah J Res Med Sci Short Communication BACKGROUND: Proper placement of central venous catheter (CVC) tip could reduce early and late catheter-related complications. Although the live fluoroscopy is standard of care for placement of the catheter, it is not available in many centers. Therefore, the present study evaluated the sensitivity and specificity of bedside chest X-ray (CXR) for proper positioning of the catheter tip. MATERIALS AND METHODS: A total of 82 adult patients undergoing elective placement of tunneled CVC were enrolled in this study during 2010-2012. The catheter tip position was evaluated by postoperative bedside chest radiographs as well as trans-thoracic echocardiogram as definite diagnostic tool. The catheter position was considered correct if the tip was positioned in the right atrium both in CXR or echocardiography. Finally, CXRs interpreted by expert radiologist. Thus findings were compared by echocardiography. Sensitivity, specificity, accuracy, positive, and negative predictive values were calculated. Data were analyzed using SPSS version 16 (SPSS Inc., Chicago, IL), and P < 0.05 considered as significant. RESULTS: The patients were 57.37 ± 18.91 years of age, weighed 65.79 ± 15.58 kg and were 166.36 ± 9.91 cm tall. Sensitivity and specificity of CXR for proper catheter tip position were 74.3% and 58.3%, respectively. Positive and negative predictive values were 91.2% and 28%. In addition accuracy, positive likelihood ratio, and negative likelihood ratio were 71.9%, 1.78, and 2.27 respectively. CONCLUSION: Bedside CXR alone does not reliably predict malpositioning after CVC placement. Medknow Publications & Media Pvt Ltd 2015-01 /pmc/articles/PMC4354071/ /pubmed/25767527 Text en Copyright: © Journal of Research in Medical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Short Communication
Salimi, Fereshteh
Hekmatnia, Ali
Shahabi, Javad
Keshavarzian, Amir
Maracy, Mohammad Reza
Jazi, Amir Hosein Davarpanah
Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title_full Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title_fullStr Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title_full_unstemmed Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title_short Evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
title_sort evaluation of routine postoperative chest roentgenogram for determination of the correct position of permanent central venous catheters tip
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354071/
https://www.ncbi.nlm.nih.gov/pubmed/25767527
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