Radiographic Findings with Central Venous Catheters

The optimal location of a central venous catheter tip is the cavoatrial junction.  Acceptable locations include:
  • Superior vena cava (including brachiocephalic - SVC junction)
  • Right atrium
  • Inferior vena cava
Central venous catheter tip at cavoatrial junction
 
Central venous catheter tip at brachiocephalic - SVC junction

 

Central venous catheter with tip in the inferior vena cava

All other locations for central venous catheter tips are considered peripheral with maximum osmolarity (900-1000 mOsm/L).

 

Click here for Parenteral Nutrition Osmolarity Calculator

 

Several factors known to increase risk of phlebitis, thrombosis, thrombophlebitis, infiltration, and extravasation when infusing high osmolarity solution including:

  • suboptimal tip location
  • patient condition
  • infusion solution

 

ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr. 2002 Jan-Feb;26(1 Suppl):1SA-138S. Erratum in: JPEN J Parenter Enteral Nutr 2002 Mar-Apr;26(2):144. PubMed PMID: 11841046.

 

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Proper central venous catheter placement

Non-central location of venous catheter tip

Non-central location of venous catheter tip

Non-central location of venous catheter tip

Non-central location of venous catheter tip

Non-central location of venous catheter tip

 

Social Media

From Home Parenteral Nutrition Program at Boston Children's Hospital Facebook Group on July 17, 2015 https://www.facebook.com/groups/HPNBostonChildrens/permalink/419813568223961/

"How often do we recommend checking X-ray to confirm central line tip location? In general for children on chronic HPN with functioning central lines, we recommend checking an X-ray to confirm the line tip location: 
- Whenever a new line is placed (even if done somewhere else),
- Once per year, child is - Every 2 years, ages 2-16,
- Whenever clinically indicated, age >16, 
http://bit.ly/1MyL4iX"