Routine chest radiography following imaging-guided placement of tunneled central lines: a waste of time, money, and radiation.
Nutr Clin Pract
; 17(2): 105-9, 2002 Apr.
Article
en En
| MEDLINE
| ID: mdl-16214971
ABSTRACT
BACKGROUND:
This study sought to evaluate routine chest radiography following placement of tunneled central lines using combined ultrasound and fluoroscopic guidance. MATERIALS ANDMETHODS:
A prospective study of 150 consecutive patients who underwent placement of tunneled central lines in the vascular radiology suite. Ultrasound-guided vein puncture was performed with an 18-gauge needle in each case, and the access site was noted. Line position was confirmed by fluoroscopy. Following the procedure, 50 patients had both an on-table digital chest radiograph and a conventional chest radiograph. Subsequent patients had a digital radiograph and a fluoroscopic image grab. Final line tip position was scored, and complications were recorded.RESULTS:
Line placement was optimal (95%) or acceptable (5%) in all patients. Line tip position could be satisfactorily evaluated on supine fluoroscopy. Mean fluoroscopic x-ray dose was 0.5 cGy/cm2. Digital chest x-ray dose was 9.0 cGy/cm2, and formal chest radiography dose was 12.0 cGy/cm2. The only complications were 2 carotid artery punctures without clinical sequelae.CONCLUSION:
When lines are placed under imaging guidance with ultrasound to direct the venous puncture, complications are rare and are not likely to be clinically important. Conventional and digital chest radiographs do not contribute clinically relevant information but do add to the radiation dose, time, and expense of the procedure.
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Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Guideline
/
Observational_studies
Idioma:
En
Revista:
Nutr Clin Pract
Asunto de la revista:
CIENCIAS DA NUTRICAO
/
ENFERMAGEM
Año:
2002
Tipo del documento:
Article