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Updated: Feb 13, 2026
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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
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Central venous catheterization for acute trauma resuscitation: Tip position analysis using routine emergency computed
Manuel F Struck1, Sebastian Ewens2, Wolfram Schummer3,4
11 Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig, Germany.
The Journal of Vascular Access
|March 14, 2018
Summary
Central venous catheter malposition is common in trauma patients, with nearly 30% of cases showing incorrect tip placement. Higher injury severity significantly predicts these malpositions, impacting patient outcomes.
Area of Science:
- Emergency Medicine
- Radiology
- Trauma Surgery
Background:
- Central venous catheter (CVC) insertion is critical for acute trauma resuscitation.
- Mechanical complications of CVC insertion are known, but precise tip positioning data is limited.
Purpose of the Study:
- To analyze central venous catheter tip positions in acute trauma patients using routine emergency computed tomography (CT).
Main Methods:
- Retrospective analysis of 97 acute multiple trauma patients requiring CVC insertion between 2010-2015.
- Evaluation of CVC tip position on emergency chest CT scans.
- Correct tip position defined as <1 cm inside the right atrium and <40° angle relative to the superior vena cava.
Main Results:
- Central venous catheter malposition was observed in 29.9% of analyzed patients.
- Malpositioned CVCs were associated with higher rates of shock (58.6% vs 33.8%) and higher mean injury severity scores (38.5 vs 31.6).
- Injury severity score was a significant predictor of CVC malposition (OR=1.039, p=0.024).
Conclusions:
- Emergency CVC placement in multiple trauma patients frequently results in tip malposition.
- Higher injury severity is significantly associated with increased risk of central venous catheter malposition.
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