Ultrasound-Guided Central Line Placement: No X-Ray Needed

No pneumothoraces were detected on chest x-ray in 1202 asymptomatic patients after ultrasound-guided central venous line placement.


With ultrasound-guided central line placement, is a postinsertion chest x-ray still necessary to assess for pneumothorax? Researchers reviewed records for 1258 real-time, ultrasound-guided, internal jugular vein central line placements and 4 external jugular vein placements performed in 1066 patients during 4 years in the vascular and interventional radiology suite at a single U.S. hospital.

Postprocedure upright chest x-rays were obtained in 1202 patients (after an average of 65 minutes); supine chest x-rays were performed as part of routine care in 66 hospitalized and bedridden patients. No patient had symptoms or radiographic evidence of pneumothorax. The authors conclude that eliminating routine postprocedure x-rays would save time and costs and reduce radiation exposure.


Citation(s):

Oner B et al. Pneumothorax following ultrasound-guided jugular vein puncture for central venous access in interventional radiology: 4 years of experience. J Intensive Care Med 2011 Jul 14; [e-pub ahead of print].