title: [The clinical tests used to determine the position of the central venous catheter].
abstract: BACKGROUND
  Chest x-ray (Rx) is the standard test to assess correct placement of a central venous catheter (CVC). Our objective was to validate the use of four clinical measures (CMs) to assess the proper placement of the line.
  
  
  METHODS
  During a period of eight month, at the Intensive Care Unit a prospective study was done. A chest Rx was always obtained to assess the position of the catheter. The CMs were: venous return; waveform of the central venous pressure (CVP); arrhythmias while advancing the guide wire and the difference between planned length in cm to be introduced and the length of the catheter introduced.
  
  
  RESULTS
  For each parameter alone the sensitivity and specificity found were: for venous return 97% and 22%, for CVP waveform changes 86% and 40%, for arrhythmias 97% and 60%, for difference between planned and real length introduced into the patient 97% and 50% respectively. According to chest x-ray, 78% of the catheters were located at a central position. Using the four CMs, we obtained 86% sensitivity and 90% specificity of the placement of the CVC.
  
  
  CONCLUSIONS
  The use of each parameter alone is highly sensitive but poorly specific.
authors.affiliation: Unidad de Cuidados Intensivos, Unidad Médica de Alta Especialidad 71, Torreón, Coahuila, Mexicano del Seguro Social, Mexico.
authors.forename: Favio
authors.initials: F
authors.lastname: Martínez-Flores
authors.forename: Horacio
authors.initials: H
authors.lastname: Márquez-González
authors.forename: Horacio
authors.initials: H
authors.lastname: Márquez-Flores
authors.forename: Esperanza Rosalba
authors.initials: ER
authors.lastname: Rodríguez-Reyes
authors.forename: María de Lourdes
authors.initials: Mde L
authors.lastname: Guerrero-Almeida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult