Aim: Central venous catheterization (CVC) is a standard intervention with various side effects such as pneumothorax. The principle of routine chest radiography following catheterization has been recently challenged. The present research seeks to develop a scoring system to select patients requiring radiography following central venous catheterization.
Material and Method: As many as 210 patients requiring central venous catheterization participated in this cross-sectional research. They were assessed and studied concerning pneumothorax risk factors including a body mass above 30, history of emphysematous disease or neck and chest cage surgery, a history of catheterization, number of punctures, inappropriate position during CVC, treatment with a ventilator. Finally, the pre- and post-catheterization chest radiographs were compared to one another, and the sensitivity and specificity of the scoring system were measured.
Results: A frequency of 5.24% was reported for pneumothorax. There was a significant correlation between the number of punctures, patientís position and history of catheterization with the occurrence of pneumothorax (P < 0.001). A frequency of 80% was observed for pneumothorax with a score above 4. This frequency was significantly more than what was noted in the group with a score less than 4 (P < 0.001; OR: 174.2). The sensitivity and specificity of the scoring system used for the score above 2 were 81.8% and 87.9% respectively.
Discussion: According to the results achieved in this research, the possibility of pneumothorax among patients with an overall score less than 2 is insignificant, and the routine radiography of the chest following the catheterization is not necessary. However in cases with a score of more than 4, the possibility of pneumothorax is higher, and it is necessary to conduct radiography with short intervals and even more than once.