Confirming Central Venous Access Position | Chest X-Ray

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1. Home
2. Investigations
3. Chest X-Ray
4. Confirming Central Venous Access Position

10/10 pages left today. Sign Up Chest X-Ray Chest X-Ray Confirming Central Venous Access Position Bookmark ShareOn this page:Central Venous Catheters (CVCs)PICC LinesVascathsPortacathsView Topic Outline

Overview

A wide range of large bore and central catheters are used in clinical practice. The chest x-ray is used to confirm that such catheters are in the correct position and are safe to use.

Central Venous Catheters (CVCs)

A central venous catheter is a large bore catheter inserted into a large vein for the purpose of central venous access.A CVC inserted via the subclavian or internal jugular vein should be within the SVC i.e. angled downward toward the right heart border, but not in the right atrium.

• Example

• A right internal jugular CVC within the superior vena cava
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• Indications for Central Venous Catheter

• Administration of certain medications - high-dose potassium, vasopressors, TPN, certain chemotherapy
• Haemodynamic monitoring - central venous pressure
• Large transfusion requirement

PICC Lines

A peripherally inserted venous catheter (PICC) line is a small but long line inserted into the arm and advanced into the central veins.A PICC line should be within the SVC i.e. angled downward toward the right heart border, but not in the right atrium.

• Examples

• A right-sided PICC line at the cavoatrial junction
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• A left-sided PICC line at the cavoatrial junction
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• A right-sided PICC line seen within the right atrium
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• Indications for PICC Line

• Administration of certain medications - high-dose potassium, vasopressors, TPN, certain chemotherapy, long-term antibiotics
• Difficult peripheral venous access - with need for frequent blood samples

Vascaths

A vascath is a wide bore catheter usually inserted into the subclavian or internal jugular vein. It may be non-tunnelled (short-term) or tunnelled (longer term).A vascath should be within the SVC i.e. angled downward toward the right heart border, but not in the right atrium.

• Examples

• A non-tunnelled vascath at the cavoatrial junction
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• A tunnelled vascath
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• Indications for Vascath

• Dialysis
• Plasmapheresis

Portacaths

A portacath is a subcutaneous port with a line inserted into the subclavian vein, usually for long-term administration of medications such as chemotherapy.

• Example

• A portacath inserted for chemotherapy in a patient with non-small cell lung cancer
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