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Positioning long lines: contrast versus plain radiography
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  • Published on:
    Identification of the tip of the long lines using inversion of image technique on PACS
    • Naharmal Soni, Senior House Officer Paediatrics
    • Other Contributors:
      • Dr Martin Becker, Dr Hilary Dixon, Dr Richard Miles (Hinchingbrooke Hospital, Huntingdon)

    Dear Editor

    We read the article by Reece et al [1] and closely followed the responses to it. We even went ahead to carry out a study looking at identification of the tip of the long lines using inversion of image technique on PACS (picture archiving and communication system).

    Background: Positioning of long lines into the heart has serious consequences including death due to cardiac tamponade.[2] The...

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    Conflict of Interest:
    None declared.
  • Published on:
    Extra-thoracic complications of central lines
    • Nilesh M Mehta, Specialist Registrar and Consultant Neonatologist
    • Other Contributors:
      • Richard M Nicholl

    Dear Editor, We read the article by Reece et al [1] and followed the subsequent correspondence with interest. In light of the recent review commissioned by The Chief Medical Officer for England, physicians must be aware of potential complications of peripherally inserted central catheters (PICC).[2] While the true incidence of such events will only be known with prospective data collection, retrospective studies s...

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    Conflict of Interest:
    None declared.
  • Published on:
    Image inversion
    • Ian Bernard, Consultant Paediatrician and Specialist Registrar
    • Other Contributors:
      • I Banerjee
    Dear Editor,

    Long lines are commonplace but putting them in the appropriate place is not so common. The article [1] advocates the use of contrast to position long lines. In a e-letter, Dr Yadav [2] argues against the use of contrast medium until safety is validated. We, at Glan Clwyd Hospital, have found that using the picture archiving and communication system (PACS), line tips are simpler to identify. We use software MedVi...

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    Conflict of Interest:
    None declared.
  • Published on:
    Where should the long line tip lie?

    Dear Editor,

    I read with interest the recommendation of Reece and colleagues regarding the positioning of long lines in preterm neonates. [1] In their methods the authors state that they aimed to place the tip of the line up to 10 mm into the right atrium (upper limb insertions). Manufacturer and standard text book of neonatology recommend that the line tip should not be sited in the right atrium as there are potenti...

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    Conflict of Interest:
    None declared.