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Assessment of Distal Tip Position of Long‐Term Central Venous Feeding Catheters Using Transesophageal Echocardiology
Author(s) -
Reynolds Nigel,
McCulloch Alan S.,
Pennington Christopher R.,
MacFadyen Robert J.
Publication year - 2001
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860710102500139
Subject(s) - medicine , catheter , chest radiograph , parenteral nutrition , central venous catheter , radiography , radiology , surgery
Background: Central vein catheter position is a vital element in promoting longevity and minimizing adverse events associated with long‐term parenteral nutrition. Traditionally, position has been verified using a chest radiograph. However, this mode of assessment has limitations as the catheter is placed in a dynamic system subject to forces from changes in posture and diaphragmatic movement. Methods: We compared the reported position using a chest x‐ray compared with assessment using transesophageal echocardiology (TOE) in 9 patients receiving home parenteral nutrition. The x‐ray was reported by a radiologist unaware of the study. Results: There were discordant results in 7 of the 9 cases with catheter tip placed in the right atrium or impinging in the tricuspid valve which was not evident from the chest x‐ray. TOE offered greater information of catheter tip position and relationship to adjacent anatomy. Conclusions: Further work is required but this observational study suggests guidelines suggesting the use of a chest radiograph to confirm catheter position may need to be re‐assessed. ( Journal of Parenteral and Enteral Nutrition 25: 39–41, 2001)