Related Experiment Videos
Changes in tunneled catheter tip position when a patient is upright
G K Nazarian1, H Bjarnason, C A Dietz
1Department of Radiology, University of Minnesota School of Medicine, Minneapolis 55455-0392, USA.
Summary
Tunneled catheter tips significantly migrate from their initial placement position to the superior vena cava when patients move to an upright position. Factors like vein entry site, patient sex, and weight influence this migration.
Area of Science:
- Vascular access device placement
- Radiological imaging
- Patient positioning
Background:
- Tunneled catheters are crucial for long-term venous access.
- Accurate initial placement is vital for function and safety.
- Patient position changes can affect catheter tip location.
Purpose of the Study:
- To quantify the positional changes of tunneled catheters from supine to upright positions.
- To identify factors influencing catheter tip migration.
Main Methods:
- 146 tunneled catheters were placed via subclavian or jugular veins.
- Initial positions documented with cine radiography.
- Follow-up chest radiographs in upright position assessed tip migration (1-8 scale).
- Correlated migration with patient sex, weight, entry site, catheter size/type.
Main Results:
- Statistically significant catheter tip migration occurred (P < .0001).
- Mean positional change was 1.5 units (e.g., mid-right atrium to low superior vena cava).
- Greater migration observed with subclavian vein placement, in females, and in obese patients.
Conclusions:
- Tunneled catheter tips demonstrate significant migration upon assuming an upright position.
- Understanding migration is key for optimal final catheter positioning.
- Subclavian catheters, female patients, and obesity are associated with increased migration.