Are routine chest radiographs necessary after image-guided placement of internal jugular central venous access devices?

Abstract

The purpose of this study was to determine the value and cost of obtaining routine chest radiographs after image-guided placement of internal jugular central venous catheters. We reviewed the records of 424 patients in whom 572 internal jugular catheters were placed by sonographic and fluoroscopic guidance over a 2-year period. Inspiratory and expiratory chest radiographs obtained immediately after each procedure were also reviewed. Routine postprocedural chest radiographs revealed no complications and did not alter the treatment of any patient. Delayed pneumothorax was detected after placement of two catheters (0.5%) when patient symptoms prompted additional radiographs. Immediate postprocedural chest radiographs are not routinely needed after image-guided insertion of internal jugular central venous catheters and unnecessarily add to the cost of patient care.