BMJ 1995;311:1091 (21 October)

Letters

Line should not enter the heart

EDITOR,--We are concerned by Andy Adam's statement that the correct position for the tip of long term central venous catheters is in the right atrium.1 Cardiac tamponade secondary to erosion or perforation of the tips of catheters is a rare but well recognised and potentially fatal complication of central venous catheterisation. Several recent reviews have drawn attention to this and recommended that the tip of a central venous catheter should lie in the superior vena cava, typically judged as being at the angle of the trachea and right main bronchus.2 3 4

Surgical senior house officer Consultant surgeon Consultant anaesthetist Weston General Hospital, Weston Super Mare BS23 4TQ

Malcolm Hilton, Geoffrey Pye, Andrew Walker 

  1. Adam A. Insertion of long term central venous catheters: time for a new look. BMJ 1995;311:341-2. (5 August.) [Free Full Text]
  2. Cherng YG, Cheng YJ, Chen TG, Wang CM, Lin CC. Cardiac tamponade in an infant. A rare complication of central venous catheterisation. Anaesthesia . . . [Full text of this article]


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Relevant Article

Insertion of long term central venous catheters: time for a new look
Andy Adam
BMJ 1995 311: 341-342. [Extract] [Full Text]

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