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Is the atrial-caval junction the optimal tip location?
Anybody have references/studies that state this? Thanks 
Positions from professional

Positions from professional organizations: 

INS 20006  Lower one third to caj

FDA CVC Working Group 1989, 1994 lower one third

AVA 1998

ONS 2004


SIR 2003

"Venous thrombosis is a potential postplacement complication of a central venous access device (VAD). Improper catheter tip position is a predisposing factor, especially when the device is used to administer parenteral nutrition (PN)."  
Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 5 2007 382-287 DeChicco et. al.
and then clips from posts from other 'posters' on this forum................
Dierks, M and E Whitman, Catheter tip position in the analysis of central venous access devises outcomes. Journal of Vascular Access Devises, 1995. 1(3): p 11-14
1.    Vesely T. Central venous catheter tip position: A continuing controversy. Journal of Vascular and Interventional Radiology. 2003;14:527-534.
2.    Vesely T. Optimal positioning of central venous catheters. Journal of Vascular Access Devices. 2002;7(3):9-12.
Spring 2008 JAVA there is an article by Peter Verhey

Mari Cordes, BS RN 

Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems 

Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center

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