An upright chest x-ray is preferred because free air will migrate to the apex of the lung, where it is easily visualized. If a pneumothorax is suspected, an upright chest x-ray should be obtained. The National Institute for Health and Clinical Excellence (UK) and other medical organizations recommend the routine use of ultrasonography to minimize complications. For experienced clinicians, the incidence of pneumothorax is about 1.5–3.1%. In the case of catheterization of the internal jugular vein, the risk of pneumothorax is minimized by the use of ultrasound guidance. The incidence of pneumothorax is highest with subclavian vein catheterization due to its anatomic proximity to the apex of the lung. The benefit expected from their use should outweigh the risk of those complications. However, there are risks and complications associated with the placement of central lines, which are addressed below.Ĭentral line insertion may cause several complications. Relative contraindications include: coagulopathy, trauma or local infection at the placement site, or suspected proximal vascular injury. There are no absolute contraindications to the use of central venous catheters. pulmonary artery catheterization) require central venous access.
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