Primary and secondary displacement of central venous catheters

The purpose of this study was to investigate the frequency of primary and secondary displacement of central venous catheters. One hundred and two central venous catheters, inserted through a peripheral or a central vein before surgery or in the intensive care unit, were controlled by chest X-ray 5-720 min after insertion. The number of primarily displaced catheters was 27. Of these, the position was corrected in 8. Thereafter, the 83 correctly placed catheters were observed for 4-560 h. The number of X-ray controls was 2-24. The number of secondary displacement was 2, whereas 12 catheters showed minimal secondary displacement. The rate of complication was very low. We conclude that chest X-ray immediately after insertion of central venous catheters is absolutely necessary, but since the number of secondary displacements is very low, daily chest X-ray control is not necessary. We also conclude that the internal jugular vein is the best route for introducing a central venous catheter, since complications are very few and the number of displacements is very low.