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Lines and tubes (radiograph)

Last revised by Daniel MacManus on 8 Mar 2025

Citation, DOI, disclosures and article data

Citation:

Hartley L, MacManus D, Campos A, et al. Lines and tubes (radiograph). Reference article, Radiopaedia.org (Accessed on 19 Mar 2025) https://doi.org/10.53347/rID-29308

DOI:

https://doi.org/10.53347/rID-29308

Permalink:

https://radiopaedia.org/articles/29308

rID:

29308

Article created:

15 May 2014, Louise Hartley

Disclosures:

At the time the article was created Louise Hartley had no recorded disclosures.

View Louise Hartley's current disclosures

Last revised:

8 Mar 2025, Daniel MacManus

Disclosures:

At the time the article was last revised Daniel MacManus had no financial relationships to ineligible companies to disclose.

View Daniel MacManus's current disclosures

Revisions:

23 times, by 15 contributors - see full revision history and disclosures

Systems:

Chest

Sections:

Approach

Synonyms:

Chest x-ray lines and tubes
Chest radiographs lines and tubes
Lines and tubes (chest x-ray)

Lines and tubes are important components in chest radiographic evaluation.

Nasogastric tube (NGT)

See: nasogastric tube positioning.

Correct position

NG tube tip ≥10 cm distal to the gastro-esophageal junction
- i.e. below the left hemidiaphragm

Complications

insertion into trachea or bronchus (pneumonia/pulmonary contusion/pulmonary laceration)
pharyngeal or esophageal perforation

Nasopharyngeal airway tube (NPAT)

See: nasopharyngeal airway tube

Correct position

Tip immediately above the epiglottis

Complications

risk of intracranial positioning in patients with basal skull fracture

Endotracheal tube (ETT)

See: evaluation of endotracheal tube position.

Correct position

ETT tip 5 cm +/- 2 cm above carina
- i.e. at level of medial ends of clavicles

Complications

selective intubation (contralateral lung collapse/hyperinflation of ipsilateral lung/pneumothorax)
tooth aspiration

Central venous line/catheter (CVL/CVC)

Correct position

CV line tip in the superior vena cava or at the superior cavoatrial junction
- i.e. at level of 1^st anterior intercostal space above the carina

Complications

insertion into right atrium or ventricle (non-bacterial thrombotic endocarditis / dysrhythmias / myocardial perforation)
mediastinal hematoma secondary to vessel perforation
pneumothorax
hemothorax
central line-associated bloodstream infection
deep venous thrombosis
line fracture +/- embolization

Intercostal tube/catheter (ICC)

See: intercostal catheter

Correct position

intercostal tube tip lies between visceral and parietal pleura
- anterosuperiorly to drain pneumothorax
- posteroinferiorly to drain pleural effusion or hemothorax

Complications

placement into lung parenchyma, interlobar fissure or subcutaneous tissue
mediastinal or abdominal visceral trauma
re-expansion pulmonary edema

Permanent pacemaker (PPM)

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

Temperature probe

See: temperature probe

Correct position

in the upper to mid thoracic esophagus

Complications

placement into trachea or bronchus
pneumomediastinum
pneumothorax

Pericardial drain

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)

Quiz questions

References

Incoming Links

Promoted articles (advertising)

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Lines and tubes (radiograph)

Citation, DOI, disclosures and article data

Nasogastric tube (NGT)

Correct position

Complications

Nasopharyngeal airway tube (NPAT)

Correct position

Complications

Endotracheal tube (ETT)

Correct position

Complications

Central venous line/catheter (CVL/CVC)

Correct position

Complications

Intercostal tube/catheter (ICC)

Correct position

Complications

Permanent pacemaker (PPM)

Correct position

Complications

Temperature probe

Correct position

Complications

Pericardial drain

Correct position

Intra-aortic balloon pump (IABP)

Correct position

Complications

See also

Quiz questions

References

Incoming Links

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