ReviewEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Rethinking routine chest radiography after central venous catheterisation: a rapid review of current evidence and alternatives.
Review in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite growing evidence supporting ultrasound (US)- and ECG-guided protocols, chest radiography (CXR) remains the most widely used method for post-procedural confirmation of central venous catheter (CVC) position in clinical practice.
methodsWe conducted a rapid review of observational studies, randomised controlled trials, systematic reviews, and guidelines comparing CXR with US- and ECG-based confirmation modalities in adult patients across ICU, emergency, and perioperative settings. Systematic searches were performed in PubMed, Scopus, and Web of Science through December 2025. Outcomes of interest included diagnostic accuracy for tip position and complications, procedural time, and clinical and economic impact.
findingsNinety-four studies were included, comprising more than 20,000 CVC placements. Evidence from meta-analyses, multicentre cohorts, and comparative studies suggests that US-based protocols – particularly those incorporating agitated saline (“bubble test”) and right-atrial visualisation – and intracavitary ECG (IC-ECG) can achieve high diagnostic performance for tip confirmation in appropriately selected patients, with several reports describing sensitivity and specificity of approximately 95% or higher. Across studies, bedside strategies enabled faster confirmation than CXR (often 15–40 min), avoided radiation exposure, and facilitated earlier detection of complications. Despite these findings, CXR remains predominant in many institutions, reflecting entrenched protocols, medico-legal considerations, and heterogeneity in training and governance.
interpretationRoutine CXR after CVC placement offers little incremental value where comprehensive US or ECG confirmation is available, implemented, and documented by trained operators. Wider adoption of US- and ECG-based protocols could improve safety, efficiency, and resource utilisation in acute care. Institutional inertia and educational gaps remain key barriers to implementation; addressing these will be crucial to aligning practice with current evidence. A pragmatic two-tier pathway – POCUS and/or IC-ECG as first-line confirmation, with selective CXR for unresolved uncertainty or high-risk scenarios – may balance efficiency with governance and medico-legal requirements.
Indexed as
Identifiers
41986702What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.