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(F)utility of "routine" postprocedural chest radiograph after hemodialysis catheter (central venous catheter) insertion.

(F) 血液透析导管 (中心静脉导管) 插入后 “常规” 术后胸片的效用。

  • 影响因子:1.12
  • DOI:10.1177/1129729820907259
  • 作者列表:"Parmar MS
  • 发表时间:2021-01-01
Abstract

:A routine postprocedural chest radiograph had been a safe, checklist-based final step of the procedure, since the start of central venous catheter insertion for hemodialysis to check the position of the catheter tip and to rule out complications. However, the chest radiograph is a suboptimal method to rule out complications like pneumothorax and is not a reliable test to confirm its position. Although it is relatively inexpensive, it is labor-intensive and exposes patient to unnecessary radiation exposure, cost, and often results in delayed use of the catheter. Various studies question the value of a routine chest radiograph as a screening test to rule out the mechanical complications of catheter insertion. We, in this brief viewpoint, present evidence to support the futility of a routine postprocedural chest radiograph in majority of asymptomatic patients and support Choosing Wisely Initiative to avoid low-value studies. However, it should be considered under specific indications, as discussed.

摘要

: 自开始为血液透析插入中心静脉导管以检查导管尖端的位置并排除并发症以来,常规术后胸片一直是安全的、基于清单的最后一步。然而,胸片是排除气胸等并发症的次优方法,并且不是确定其位置的可靠测试。虽然它相对便宜,但它是劳动密集型的,并且使患者暴露于不必要的辐射暴露、成本,并且经常导致导管的延迟使用。各种研究质疑常规胸片作为排除导管插入机械并发症的筛选试验的价值。在这个简短的观点中,我们提出了证据来支持在大多数无症状患者中进行常规术后胸片检查是徒劳的,并支持明智地主动选择以避免低价值研究。然而,如所讨论的,应在具体适应症下考虑。

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