Analysis of chest X-ray plain film images of intravenous ports inserted via the superior vena cava

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• 作者：Jui-Ying Fu (1) (2)
  Ching-Feng Wu (3)
  Po-Jen Ko (3)
  Ching-Yang Wu (3)
  Tsung-Chi Kao (3)
  Sheng-Yueh Yu (3)
  Yun-Hen Liu (3)
  Hung-Chang Hsieh (3)
  
• 关键词：Chest X ; ray plain film ; Intravenous ports ; Superior vena cava
• 刊名：Surgery Today
• 出版年：2014
• 出版时间：August 2014
• 年：2014
• 卷：44
• 期：8
• 页码：1513-1521
• 全文大小：542 KB
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• 作者单位：Jui-Ying Fu (1) (2)
  Ching-Feng Wu (3)
  Po-Jen Ko (3)
  Ching-Yang Wu (3)
  Tsung-Chi Kao (3)
  Sheng-Yueh Yu (3)
  Yun-Hen Liu (3)
  Hung-Chang Hsieh (3)
  
  1. Division of Chest Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan
  2. Division of Chest and Critical Care, Department of Internal Medicine, Saint Paul Hospital, Taoyuan, Taiwan
  3. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Shing Street, Kweishan, Taoyuan, 333, Taiwan
  
• ISSN：1436-2813

文摘

Purposes The optimal tip position for an intravenous port and the angle between the locking nut and the catheter are still debatable. This study evaluates the use of chest X-ray plain films for screening patients with potential intravenous port complications. Methods We reviewed, retrospectively, 1505 patients who had an intravenous port implanted between January 1 and December 31, 2006 at Chang Gung Memorial Hospital, and were followed up until June 30, 2010. Of the 1119 patients with an intravenous port implanted via the superior vena cava (SVC), 279 underwent re-interventions for complications. There were four different types of single lumen port, and entry vessels on the right side were utilized as the predominant entry sites through the vessel cut-down method for catheter cannulation. The anatomic catheter tip was confirmed on the postero-anterior view of plain chest X-ray films. We used the Picture Arching and Communicating System (PACS) (GE, Fairfield, CT, USA) to record the angle and distance in degrees and centimeters, respectively. Results The tracheal carina was seen easily on the chest X-ray plain film and the location of the catheter tip and the angle between the locking nut and the catheter were identified. The location of the catheter tip was significantly related to migration (p? Conclusion The ideal position of an intravenous port to avoid migration is 0.68?cm below the carina. For surgeons, a quantified reference may minimize technical errors. Patients with shallow tip location should be followed up regularly and aggressive intervention initiated for any intravenous port malfunction.