LinesTubes.com - Lines, Tubes, and Devices in the Upper Mediastinum

Endotracheal Tube

aka ETT. Used for supported ventilation. An endotracheal tube should be positioned in the trachea ideally midway between the vocal cords and carina.

Feeding Tube

The feeding tube, often referred to as Dobhoff after its inventors, is slightly different from the nasogastric tube in that it is typically used for feeding (hence the name). It has a small opening at the side of the tip, which is radiopaque. You may also see the stiffening wire, as in this example, although that is removed before use.

Nasogastric Tube

Tube generally used to drain/decompress the stomach. It has both an end-hole and a side-hole, both of which should be placed within the stomach.

Tracheostomy

Permanent airway device.

Central Venous Catheter

Denver Shunt

aka peritoneovenous shunt. Takes ascites to the venous system (generally internal jugular vein), traversing the chest wall. The radiolucent portion is the one-way valve.

Esophageal Doppler Probe

Used for non-invasive hemodynamic monitoring. Note the distinctive rectangular tip.

Esophageal Temperature Probe

Braided-wire probe with radiopaque tip providing internal temperature monitoring.

Hemodialysis Catheter

Dual lumen central venous catheter, often tunneled, for short term dialysis access. The two lumens terminate at slightly different positions - the proximal opening is generally used for inflow ("arterial") and the distal opening is used for blood return ("venous"). The distal lumen should ideally lie within the right atrium.

Left Ventricular Assist Device

Abbreviated LVAD. There are several different models of slightly varying size. The inflow cannula is generally radiopaque and lies at the left ventricular apex. The outflow cannula is generally radiolucent and plugs into the ascending aorta.

PICC

Peripherally inserted central venous catheter, used as an intermediate-term venous access. It is placed in the brachial or cephalic veins of the upper extremities (sometimes in the scalp or lower extremities in babies). The tip should ideally terminate at the superior cavoatrial junction.

Occasionally, the PICC will terminate within the axillary or subclavian vein, in which case it is referred to as a 'midline catheter' (since it is not central).

Port Catheter

More permanent method of central venous access, consisting of a plastic/metal reservoir in the subcutaneous tissues and an intravenous catheter.

May be single lumen or, as in this case, dual lumen. Typically ports compatible with CT power injector will have a radiopaque "CT" marker on the reservoir.

Retained Guidewire

The guidewire used to place a central line using Seldinger technique may be inadvertently left behind after central line placement. These wires often have a 'J' tip, as in this case.

Note that this wire enters from the IVC, likely a femoral central line, and terminates in the left brachiocephalic vein.

Transesophageal Echo Probe (TEE)

Used only intraoperatively to monitor cardiac surgery.

Ventriculoatrial Shunt

This may be indistinguishable from an internal jugular central venous catheter, although the high position in the neck might be a clue. This takes CSF from the ventricles into the SVC/right atrium.

Esophageal Stent

Typically used for obstructing tumors but can also be used for small perforations or fistulas.