Bedside prediction of the central venous catheter insertion depth

Ryu, Ho-Geol; Bahk, Jae Hyon; Kim, Jin‐Tae; Lee, J.-H.

doi:10.1093/bja/ael339

Cited by 49 publications

(51 citation statements)

References 14 publications

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“…Although the ideal position of the catheter tip is controversial, location in the superior vena cava (SVC) just above the pericardial reflection on a conventional radiograph is considered ideal to minimize the risks of cardiac tamponade and venous thrombosis [11]. Although several techniques to localize the catheter-tip and rule out malposition after CVC/PICC insertion have been investigated [12][13][14][15][16][17], portable chest radiography is currently considered the gold standard in imaging. However, its accuracy relative to tip localization may well be overestimated [18].…”

Section: Introductionmentioning

confidence: 99%

Bedside Ultrasound can Safely Eliminate the Need for Chest Radiographs after Central Venous Catheter Placement: CVC Sono in the Surgical ICU (SICU)

Matsushima

Frankel

2010

Journal of Surgical Research

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Section: Introductionmentioning

confidence: 99%

Bedside Ultrasound can Safely Eliminate the Need for Chest Radiographs after Central Venous Catheter Placement: CVC Sono in the Surgical ICU (SICU)

Matsushima

Frankel

2010

Journal of Surgical Research

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“…Kim et al 17 showed that the optimal catheter insertion length during right subclavian venous cannulation was 12.9 ± 0.9 cm, while Ryu et al 5 suggested that 13.8 cm (10.5---18.0 cm) of subclavian venous catheter insertion would be optimal when the infra-clavicular landmark approach was used. However, this fixed length does not consider height, the preferred insertion point of the practitioner, or the method of subclavian venous cannulation, all of which might influence the final location of the catheter tip.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, the internal jugular vein and the subclavian vein can be found easily beneath the ipsilateral clavicular notch, which is the site of articulation with the sternal end of the clavicle and can be readily palpated by hand. 6,20 Therefore, in another study, 5 the carina served as a landmark of adequate subclavian vein insertion length together with an estimate of the insertion length, which was calculated on the basis of a chest radiograph taken before central venous catheter insertion by adding (i) the distance between the insertion point of needle to the ipsilateral clavicular notch to (ii) the vertical distance between the ipsilateral clavicular notch to the carina. However, this method has some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study 5 suggested that adding (i) the distance between the insertion point of needle and the ipsilateral clavicular notch to (ii) the vertical distance between the carina and the ipsilateral clavicular notch generates a reliable tip position near the carina level that guides suitable and safe positioning of the central venous catheter tip above the pericardial reflection. 1 However, this method has some limitations.…”

Section: Previsão Do Comprimento De Inserção De Cateter Em Veia Subclmentioning

confidence: 99%

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Bedside prediction of right subclavian venous catheter insertion length

Choi

Hahm

Kwon

et al. 2014

Brazilian Journal of Anesthesiology (English Edition)

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Background and objective: The present study aimed to evaluate whether right subclavian vein (SCV) catheter insertion depth can be predicted reliably by the distances from the SCV insertion site to the ipsilateral clavicular notch directly (denoted as I-IC), via the top of the SCV arch, or via the clavicle (denoted as I-T-IC and I-C-IC, respectively). Method: In total, 70 SCV catheterizations were studied. The I-IC, I-T-IC, and I-C-IC distances in each case were measured after ultrasound-guided SCV catheter insertion. The actual length of the catheter between the insertion site and the ipsilateral clavicular notch, denoted as L, was calculated by using chest X-ray. Results: L differed from the I-T-IC, I-C-IC, and I-IC distances by 0.14 ± 0.53, 2.19 ± 1.17, and −0.45 ± 0.68 cm, respectively. The mean I-T-IC distance was the most similar to the mean L (intraclass correlation coefficient = 0.89). The mean I-IC was significantly shorter than L, while the mean I-C-IC was significantly longer. Linear regression analysis provided the following formula: Predicted SCV catheter insertion length (cm) = −0.037 + 0.036 × Height (cm) + 0.903 × I-T-IC (cm) (adjusted r 2 = 0.64). Conclusion: The I-T-IC distance may be a reliable bedside predictor of the optimal insertion length for a right SCV cannulation.

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“…Therefore, measurement errors of the projection, p.a. or a.p., due to the parallax effect in CXR are negligible [11,12].…”

Section: Carina-tip Length and Laterality Onmentioning

confidence: 99%

Early Flow Disturbances of Tunnelled Haemodialysis Catheters and Topographic Landmarks in Chest X-Ray

et al. 2018

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Background/Aims: The position of the tip of tunnelled haemodialysis (HD) catheters (THC) might influence flow characteristics during HD. In chest X-ray (CXR), carina-related landmarks may be practicable to verify the THC position, and tip-carina distance (TCD) might be useful to predict early-flow dysfunctions. Methods: In this single-centre, retrospective study, the TCD and the angle between the distal catheter and the body vertical axis (tip-body vertical-angle [TVA]) was measured in 115 THC by post-procedure CXR with 2 investigators. The parameters were proved to be feasible by interrater-reliability and correlated with the incidence of flow-dysfunction within 10 days after insertion. Results: Steep-aligned (TVA <40°, p < 0.01) and deep-ending catheters (TCD: right-sighted >1.5 cm or left-sighted >4.5 cm below the carina; p < 0.01) showed a significantly less dysfunction with a good interrater-reliability (R[TVA] = 0.8, R[TCD] = 0.9). Conclusions: Carina-related landmarks in CXR might be helpful to predict early-flow dysfunctions. However, randomized studies will be necessary to confirm this in fluoroscopic-guided placement during the insertion of THC.

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Bedside prediction of the central venous catheter insertion depth

Abstract: 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.

Cited by 49 publications

References 14 publications

Bedside Ultrasound can Safely Eliminate the Need for Chest Radiographs after Central Venous Catheter Placement: CVC Sono in the Surgical ICU (SICU)

Bedside Ultrasound can Safely Eliminate the Need for Chest Radiographs after Central Venous Catheter Placement: CVC Sono in the Surgical ICU (SICU)

Bedside prediction of right subclavian venous catheter insertion length

Early Flow Disturbances of Tunnelled Haemodialysis Catheters and Topographic Landmarks in Chest X-Ray

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