{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:51:13Z","timestamp":1762505473486},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T00:00:00Z","timestamp":1240876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:p><jats:bold>Background: <\/jats:bold> Knowledge of the radiographic catheter tip position after central venous cannulation is normally not required for short\u2010term catheter use. Detection of a possible iatrogenic pneumothorax may nevertheless justify routine post\u2010procedure chest X\u2010ray. Our aim was to design a clinical decision rule to select patients for radiographic evaluation after central venous cannulation.<\/jats:p><jats:p><jats:bold>Methods: <\/jats:bold> A total of 2230 catheterizations performed using external jugular, internal jugular or subclavian venous approaches during a 4\u2010year period were included consecutively. Information on patient data and corresponding procedures was recorded prospectively. A post\u2010procedure chest X\u2010ray was obtained after each cannulation.<\/jats:p><jats:p><jats:bold>Results: <\/jats:bold> Thirteen cases (0.58%) of cannulation\u2010associated pneumothorax were identified. The risk of pneumothorax after a technically difficult (1.8%) or subclavian (1.6%) cannulation was significantly higher than after cannulation not considered as difficult (0.37%) or performed using other routes (0.33%). Clinical signs of pneumothorax within 8\u2003h of cannulation were found in all seven patients with pneumothorax requiring specific treatment. A new clinical decision rule for radiographic evaluation after central venous cannulation based on the results of the present study shows that 48% of the post\u2010procedure chest X\u2010rays performed in our patients were clinically redundant.<\/jats:p><jats:p><jats:bold>Conclusion: <\/jats:bold> Clinical symptoms were reported in all patients with pneumothorax requiring specific treatment. Approximately half of the post\u2010procedure chest X\u2010ray controls could be avoided using the proposed clinical decision rule to select patients for radiographic evaluation after central venous cannulation. A large prospective multi\u2010centre study should be carried out to further evaluate this decision rule.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2009.01980.x","type":"journal-article","created":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T09:32:25Z","timestamp":1240911145000},"page":"1145-1152","source":"Crossref","is-referenced-by-count":24,"title":["Routine chest X\u2010ray is not required after a low\u2010risk central venous 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