Difference between revisions of "Template:Central venous catheter tip position in X-ray and fluoroscopy"
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===Catheter tip position=== | ===Catheter tip position=== | ||
[[File:Optimal central venous catheter tip location.jpg|thumb|Optimal central venous catheter tip location.]] | [[File:Optimal central venous catheter tip location.jpg|thumb|Optimal central venous catheter tip location.]] | ||
| − | The distal tip of jugular catheters should lie in the lower part of the superior vena cava.<ref name=uptodate>{{cite web|url=https://www.uptodate.com/contents/placement-of-jugular-venous-catheters|title=Placement of jugular venous catheters|author=Mark P Androes, Alan C Heffner|website=UpToDate}} This topic last updated: Apr 24, 2018.</ref> For left-sides catheters, a tip in the upper right atrium has also been suggested.<ref name=uptodate/> However, the cardiac silhouettes are regarded as not reliable for this purpose, compared to using the carina as a landmark.<ref name=uptodate/> Hence, a catheter tip between 55 and 30 mm below the level of the carina is regarded as acceptable placement on anteroposterior X-rays.<ref name="VenugopalKoshy2013">{{cite journal|last1=Venugopal|first1=AchuthanNair|last2=Koshy|first2=RachelCherian|last3=Koshy|first3=SumodM|title=Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature|journal=Journal of Anaesthesiology Clinical Pharmacology|volume=29|issue=3|year=2013|pages=397–400|issn=0970-9185|doi=10.4103/0970-9185.117114|pmc=3788245|pmid=24106371}}</ref> | + | '''Regular catheters''':<br>The distal tip of jugular catheters should lie in the lower part of the superior vena cava.<ref name=uptodate>{{cite web|url=https://www.uptodate.com/contents/placement-of-jugular-venous-catheters|title=Placement of jugular venous catheters|author=Mark P Androes, Alan C Heffner|website=UpToDate}} This topic last updated: Apr 24, 2018.</ref> For left-sides catheters, a tip in the upper right atrium has also been suggested.<ref name=uptodate/> However, the cardiac silhouettes are regarded as not reliable for this purpose, compared to using the carina as a landmark.<ref name=uptodate/> Hence, a catheter tip between 55 and 30 mm below the level of the carina is regarded as acceptable placement on anteroposterior X-rays.<ref name="VenugopalKoshy2013">{{cite journal|last1=Venugopal|first1=AchuthanNair|last2=Koshy|first2=RachelCherian|last3=Koshy|first3=SumodM|title=Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature|journal=Journal of Anaesthesiology Clinical Pharmacology|volume=29|issue=3|year=2013|pages=397–400|issn=0970-9185|doi=10.4103/0970-9185.117114|pmc=3788245|pmid=24106371}}</ref> |
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| + | '''Central dialysis catheters:''' | ||
| + | *The tip of nontunneled jugular hemodialysis catheters should be in the superior vena cava, and not in the right atrium.<ref name=uptodate>{{cite web|url=https://www.uptodate.com/contents/central-catheters-for-acute-and-chronic-hemodialysis-access#H79682089|title=Central catheters for acute and chronic hemodialysis access|author=Steven J Bander, Karen Woo|website=UpToDate}} This topic last updated: Mar 27, 2018.</ref> | ||
| + | *The tip of high-flow tunneled hemodialysis catheters should be within the right upper atrium.<ref name=uptodate/> | ||
| + | |||
| + | For catheters positioned to low or high, estimate the difference between the current and optimal placement. | ||
Revision as of 21:50, 12 April 2019
Catheter tip position
Regular catheters:
The distal tip of jugular catheters should lie in the lower part of the superior vena cava.[1] For left-sides catheters, a tip in the upper right atrium has also been suggested.[1] However, the cardiac silhouettes are regarded as not reliable for this purpose, compared to using the carina as a landmark.[1] Hence, a catheter tip between 55 and 30 mm below the level of the carina is regarded as acceptable placement on anteroposterior X-rays.[2]
Central dialysis catheters:
- The tip of nontunneled jugular hemodialysis catheters should be in the superior vena cava, and not in the right atrium.[1]
- The tip of high-flow tunneled hemodialysis catheters should be within the right upper atrium.[1]
For catheters positioned to low or high, estimate the difference between the current and optimal placement.
- ↑ 1.0 1.1 1.2 1.3 1.4 Mark P Androes, Alan C Heffner. Placement of jugular venous catheters. UpToDate. This topic last updated: Apr 24, 2018. Cite error: Invalid
<ref>tag; name "uptodate" defined multiple times with different content - ↑ Venugopal, AchuthanNair; Koshy, RachelCherian; Koshy, SumodM (2013). "Role of chest X-ray in citing central venous catheter tip: A few case reports with a brief review of the literature ". Journal of Anaesthesiology Clinical Pharmacology 29 (3): 397–400. doi:. ISSN 0970-9185. PMID 24106371.
