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With ultrasound-guided central line placement, is a postinsertion chest x-ray still necessary to assess for pneumothorax? Researchers reviewed records for 1258 real-time, ultrasound-guided, internal jugular vein central line placements and 4 external jugular vein placements performed in 1066 patients during 4 years in the vascular and interventional radiology suite at a single U.S. hospital.
Postprocedure upright chest x-rays were obtained in 1202 patients (after an average of 65 minutes); supine chest x-rays were performed as part of routine care in 66 hospitalized and bedridden patients. No patient had symptoms or radiographic evidence of pneumothorax. The authors conclude that eliminating routine postprocedure x-rays would save time and c…