A chest X-ray may demonstrate immediate complications following CVC placement, or incorrect positioning
Some incorrect catheter positions are associated with long term complications
A chest X-ray taken after central venous catheter placement can identify immediate complications such as pneumothorax or pneumomediastinum.
The X-ray may also be used to identify incorrect positioning and, therefore, help reduce the risk of delayed complications such as pericardial tamponade or vessel wall erosion.
Immediate complications
Complications such as pneumothorax and surgical emphysema may arise from traumatic placement.
This peripherally inserted central catheter (PICC) was aimed to be inserted with its tip at the level of the cavo-atrial junction (the height of two vertebral bodies below the carina)
The PICC has been inserted too far with its tip in the right atrium (RA)
Note: Some large haemodialysis catheters are designed to be placed with their tip in the RA
Catheters placed via a left-sided approach are prone to being positioned nearly horizontally rather than vertically within the SVC
Catheters which contact the lateral wall of the SVC in this way may cause vessel erosion if positioned long term, and should therefore be placed so the tip is orientated vertically (see previous page)
A nasogastric tube is also in situ (not fully imaged)
