Thursday August 10, 2006
Level of central line tip may predispose to thrombosis

Interesting retrospective review of 428 central lines (inserted into 334 patients) was done in UK to look into the level central line tip's relation to thrombosis 1. The median follow-up was 72 days.

* The chest radiograph obtained post-catheter insertion, as well as follow-up radiographs, linograms, venograms and Doppler ultrasounds (US), were reviewed.

They found that: "There was a significant difference in thrombosis rate between lines sited with the tip in a distal third of the superior vena cava (2.6%) compared with a proximal third of the superior vena cava (41.7%) - CVC with tips in a proximal position were 16 times more likely to thrombose than those in a distal position".


Related previous pearls:

1. CXR reading for optimum tip of central line
2. What if SC central line ends up in IJ vein?
3. Peres-nomogram

Reference:
1. To clot or not to clot? That is the question in central venous catheters - Clinical Radiology, Volume 59, Issue 4, April 2004, Pages 349-355