SHERP

Bedside prediction of the central venous catheter insertion depth

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Authors
Ryu, H. G.; Bahk, J. H.; Kim, J. T.; Lee, J. H.
Issue Date
2007-01-11
Publisher
Oxford University Press
Citation
Br J Anaesth. 2007 Feb;98(2):225-7. Epub 2007 Jan 8.
Keywords
AdolescentAdultAgedAged, 80 and overAnthropometry/methodsCatheterization, Central Venous/*methodsClavicle/anatomy & histology/radiographyFemaleHumansJugular VeinsMaleMiddle AgedNeedlesPoint-of-Care SystemsSubclavian VeinTrachea/anatomy & histology/radiography
Abstract
BACKGROUND: The carina level has been shown to be near the pericardial reflection and can easily be identified as a landmark on a routine chest radiography. The purpose of this study was to reveal a simple method to predict the adequate central venous catheter (CVC) depth, hereby facilitating safe positioning of the CVC tip. METHODS: Central venous catheterization was performed via the right internal jugular vein (IJV) or the right subclavian vein (SCV). The CVC was placed at a depth derived by adding the length between the needle insertion point and the clavicular notch and the vertical length between the clavicular notch and the carina on the chest radiograph. The distance between the CVC tip and the carina was measured on the postoperative chest radiograph. RESULTS: The tip position of 100 CVCs placed via the right IJV was 0.1 (1.1) cm [mean (SD)] below the carina (95% CI: 0.3 cm below carina-0.2 cm above carina) and the tip position of 153 CVCs placed via the right SCV was 0.0 (1.2) cm [mean (SD)] below the carina (95% CI: 0.2 cm below carina-0.2 cm above carina). There were nine outliers (two in IJV group and seven in SCV group). CONCLUSIONS: When CVCs are inserted to a depth derived by adding the length between the needle insertion point and the clavicular notch and the vertical length between the clavicular notch and the carina, the CVC tip can be reliably placed near the carina level.
ISSN
0007-0912 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17210734

http://hdl.handle.net/10371/26963
DOI
https://doi.org/10.1093/bja/ael339
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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