Lines and tubes (chest radiograph)

Lines and tubes are important components in chest radiographic evaluation.

Nasogastric (NG) tube

See: nasogastric tube positioning

Correct position
Complications
Endotracheal tube (ETT)

See: evaluation of endotracheal tube position.

Correct position
  • ETT tip 5 cm +/- 2 cm above carina
Complications
  • selective intubation (contralateral lung collapse/hyperinflation of ipsilateral lung/pneumothorax)
  • tooth aspiration
Central venous line/catheter (CVL/CVC)
Correct position
Complications
Intercostal tube/catheter (ICC)

See: intercostal catheter

Correct position
  • intercostal tube tip lies between visceral and parietal pleura
Complications
  • placement into lung parenchyma, interlobar fissure or subcutaneous tissue
  • mediastinal or abdominal visceral trauma
  • re-expansion pulmonary edema
Pacemakers
Correct position
  • single chamber: electrode tip in right atrial appendage (atrial pacing) or right ventricular apex (ventricular pacing)
  • dual chamber: electrode tips in right atrium and right ventricular apex
  • biventricular: electrode tips in right atrium, right ventricle and coronary sinus
  • implantable converter defibrillator: electrode tip in apex of right ventricle
Complications
  • lead malposition (dysrhythmias)
  • pneumothorax
  • myocardial perforation
  • lead fracture
Thermometer probes
Correct position
  • in the upper to mid thoracic esophagus
Complications
  • placement into trachea or bronchus
  • pneumomediastinum
  • pneumothorax
Pericardial drains
Correct position
  • usually inserted on the left of midline into the pericardial space
Intra-aortic balloon pump (IABP)

See: Intra-aortic balloon pump

Correct position
  • tip at the level of the AP window
Complications
  • aortic dissection
  • obstruction of the left subclavian artery (too high)
  • obstruction of the splanchnic arteries (too low)
Chest
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Article information

rID: 29308
System: Chest
Section: Approach
Synonyms or Alternate Spellings:
  • Chest x-ray lines and tubes
  • Chest radiographs lines and tubes
  • Lines and tubes (chest x-ray)

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Cases and figures

  • Case 1(a): NG tube (correct position)
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  • Case 1(b): NG tube in right main bronchus
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  • Case 2: ET tube in right main bronchus
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  • Portable CXR
    Case 3: central line in left internal mammary vein
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  • Case 4(a): pneumothorax with intercostal tube
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  • Case 4(b): Intercostal tube in subcutaneous tissue
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  • Case 5(b): dual chamber pacemaker
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  • Case 5(d): implantable converter defibrillator
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  • pre exchange
    Case 5(e): pacemaker lead fracture
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  • Case 6: thermometer probe in LMB
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  • Case 7: pericardial drain
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  • Case 8a: Intra-aortic balloon pump (correct position)
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  • Case 8b: intra-aortic ballon pump too high
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  • Case 8c: intra-aortic ballon pump too low
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