TY - JOUR
T1 - Changes in tunneled catheter tip position when a patient is upright
AU - Nazarian, Gwen K.
AU - Bjarnason, Haraldur
AU - Dietz, Charles A
AU - Bernadas, Casandra A.
AU - Hunter, David W.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1997
Y1 - 1997
N2 - PURPOSE: To determine the relative changes in position of tunneled catheters from supine to upright patient position and factors affecting catheter tip migration. MATERIALS AND METHODS: One hundred forty-six different tunneled catheters were placed through the subclavian or jugular veins radiologically, and catheter positions were documented with use of cine radiography at the time of placement. Follow-up chest radiographs were obtained with the patient in the upright position within 48 hours after placement. Catheter tip positions were numbered from 1 to 8, with 1 representing the innominate/superior vena cava junction and 8, the lower right atrium. Patient sex and weight, the site of catheter entry, and the size and type of catheter were correlated with the relative change in position on the follow-up chest radiographs. RESULTS: There was a statistically significant (P < .0001) change in catheter position on the follow-up chest radiographs, with a mean difference of 1.5 catheter positions (usually mid-right atrium initially to low superior vena cava on follow-up). Catheter tip migration was greater for catheters in the subclavian veins, in females, and in obese patients. CONCLUSIONS: The catheter tip migrates significantly from the initial position at the time of placement as compared to when the patient assumes the upright position. This knowledge is important in achieving the desired final catheter position.
AB - PURPOSE: To determine the relative changes in position of tunneled catheters from supine to upright patient position and factors affecting catheter tip migration. MATERIALS AND METHODS: One hundred forty-six different tunneled catheters were placed through the subclavian or jugular veins radiologically, and catheter positions were documented with use of cine radiography at the time of placement. Follow-up chest radiographs were obtained with the patient in the upright position within 48 hours after placement. Catheter tip positions were numbered from 1 to 8, with 1 representing the innominate/superior vena cava junction and 8, the lower right atrium. Patient sex and weight, the site of catheter entry, and the size and type of catheter were correlated with the relative change in position on the follow-up chest radiographs. RESULTS: There was a statistically significant (P < .0001) change in catheter position on the follow-up chest radiographs, with a mean difference of 1.5 catheter positions (usually mid-right atrium initially to low superior vena cava on follow-up). Catheter tip migration was greater for catheters in the subclavian veins, in females, and in obese patients. CONCLUSIONS: The catheter tip migrates significantly from the initial position at the time of placement as compared to when the patient assumes the upright position. This knowledge is important in achieving the desired final catheter position.
KW - Catheters and catheterization
KW - Central venous access
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U2 - 10.1016/S1051-0443(97)70585-2
DO - 10.1016/S1051-0443(97)70585-2
M3 - Article
C2 - 9152918
AN - SCOPUS:0030819241
SN - 1051-0443
VL - 8
SP - 437
EP - 441
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 3
ER -