Changes in tunneled catheter tip position when a patient is upright

Gwen K. Nazarian, Haraldur Bjarnason, Charles A Dietz, Casandra A. Bernadas, David W. Hunter

Research output: Contribution to journalArticlepeer-review

93 Scopus citations

Abstract

PURPOSE: To determine the relative changes in position of tunneled catheters from supine to upright patient position and factors affecting catheter tip migration. MATERIALS AND METHODS: One hundred forty-six different tunneled catheters were placed through the subclavian or jugular veins radiologically, and catheter positions were documented with use of cine radiography at the time of placement. Follow-up chest radiographs were obtained with the patient in the upright position within 48 hours after placement. Catheter tip positions were numbered from 1 to 8, with 1 representing the innominate/superior vena cava junction and 8, the lower right atrium. Patient sex and weight, the site of catheter entry, and the size and type of catheter were correlated with the relative change in position on the follow-up chest radiographs. RESULTS: There was a statistically significant (P < .0001) change in catheter position on the follow-up chest radiographs, with a mean difference of 1.5 catheter positions (usually mid-right atrium initially to low superior vena cava on follow-up). Catheter tip migration was greater for catheters in the subclavian veins, in females, and in obese patients. CONCLUSIONS: The catheter tip migrates significantly from the initial position at the time of placement as compared to when the patient assumes the upright position. This knowledge is important in achieving the desired final catheter position.

Original languageEnglish (US)
Pages (from-to)437-441
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume8
Issue number3
DOIs
StatePublished - 1997

Keywords

  • Catheters and catheterization
  • Central venous access

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