Depth of Insertion of Right Internal Jugular Central Venous Catheter: Comparison of Topographic and Formula Methods

Overview

Journal Saudi J Anaesth

Specialty Anesthesiology

Date 2016 Jul 5

PMID 27375377

Citations 4

Authors

M Vinay

C A Tejesh

Affiliations

Soon will be listed here.

Abstract

Background: Central venous catheters (CVCs) are inserted in many critically ill patients, but there is no gold standard in estimating their approximate depth of insertion. Many techniques have been described in literature. In this study, we compare the topographic method with the standard formula technique.

Materials And Methods: 260 patients, in whom central venous catheterization was warranted, were randomly assigned to either topographic method or formula method (130 in each group). The position of the CVC tip in relation to carina was measured on a postprocedure chest X-ray. The primary endpoint was the need for catheter repositioning.

Results: The majority of the CVCs tips positioned by the formula method were situated below the carina, and 68% of these catheters required repositioning after obtaining postprocedure chest X-ray (P < 0.001).

Conclusion: The topographic method is superior to formula approach in estimating the depth of insertion of right internal jugular CVCs.

Citing Articles

"Rapid Atrial Swirl Sign": A Better Tool Than the Landmark Technique for Ensuring Correct Depth of Insertion of Central Venous Catheters.

Kairidibo , Pandey A, Dwivedi V, Prakash S, Rath A, Reena Cureus. 2024; 16(7):e65211.

PMID: 39184717 PMC: 11343511. DOI: 10.7759/cureus.65211.

Evaluation of the position of the central venous catheter tip of implantable venous access devices in the occurrence of postoperative thrombotic and non-thrombotic complications.

Hamri H, Pop C, Mauriac S, Degreve C, Khaled C, Vouche M Support Care Cancer. 2024; 32(6):355.

PMID: 38750256 DOI: 10.1007/s00520-024-08563-7.

Assessment of the Tip Position of Central Venous Catheters Inserted Using Peres' Height Formula.

Sahinkaya H, Parlak M, Tekgul Z Cureus. 2023; 14(11):e31988.

PMID: 36589175 PMC: 9797751. DOI: 10.7759/cureus.31988.

An interesting case of central venous catheter misplacement.

Pavithran P, Sekhar B, Shameer M, Manchakkal N Saudi J Anaesth. 2022; 16(1):135-136.

PMID: 35261610 PMC: 8846246. DOI: 10.4103/sja.sja_523_21.

References

Kim M, Kim K, Choi Y, Kim D, Kwon M, Sung J . An estimation of right- and left-sided central venous catheter insertion depth using measurement of surface landmarks along the course of central veins. Anesth Analg. 2011; 112(6):1371-4. DOI: 10.1213/ANE.0b013e31820902bf. View

Ryu H, Bahk J, Kim J, Lee J . Bedside prediction of the central venous catheter insertion depth. Br J Anaesth. 2007; 98(2):225-7. DOI: 10.1093/bja/ael339. View

Stonelake P, Bodenham A . The carina as a radiological landmark for central venous catheter tip position. Br J Anaesth. 2006; 96(3):335-40. DOI: 10.1093/bja/aei310. View

Wilson R, Gaer J . Right atrial electrocardiography in placement of central venous catheters. Lancet. 1988; 1(8583):462-3. DOI: 10.1016/s0140-6736(88)91247-0. View

Caruso L, Gravenstein N, Layon A, Peters K, Gabrielli A . A better landmark for positioning a central venous catheter. J Clin Monit Comput. 2003; 17(6):331-4. DOI: 10.1023/a:1024286119090. View

Czepizak C, OCallaghan J, Venus B . Evaluation of formulas for optimal positioning of central venous catheters. Chest. 1995; 107(6):1662-4. DOI: 10.1378/chest.107.6.1662. View

Rutherford J, Merry A, Occleshaw C . Depth of central venous catheterization: an audit of practice in a cardiac surgical unit. Anaesth Intensive Care. 1994; 22(3):267-71. DOI: 10.1177/0310057X9402200303. View

Lee J, Bahk J, Ryu H, Jung C, Jeon Y . Comparison of the bedside central venous catheter placement techniques: landmark vs electrocardiogram guidance. Br J Anaesth. 2009; 102(5):662-6. DOI: 10.1093/bja/aep046. View

Aslamy Z, Dewald C, Heffner J . MRI of central venous anatomy: implications for central venous catheter insertion. Chest. 1998; 114(3):820-6. DOI: 10.1378/chest.114.3.820. View

10.

Andropoulos D, Stayer S, Bent S, Campos C, Bezold L, Alvarez M . A controlled study of transesophageal echocardiography to guide central venous catheter placement in congenital heart surgery patients. Anesth Analg. 1999; 89(1):65-70. DOI: 10.1097/00000539-199907000-00012. View

11.

Schuster M, Nave H, Piepenbrock S, Pabst R, Panning B . The carina as a landmark in central venous catheter placement. Br J Anaesth. 2000; 85(2):192-4. View

12.

Jeon Y, Ryu H, Yoon S, Kim J, Bahk J . Transesophageal echocardiographic evaluation of ECG-guided central venous catheter placement. Can J Anaesth. 2006; 53(10):978-83. DOI: 10.1007/BF03022525. View

13.

Ezri T, Weisenberg M, Sessler D, Berkenstadt H, Elias S, Szmuk P . Correct depth of insertion of right internal jugular central venous catheters based on external landmarks: avoiding the right atrium. J Cardiothorac Vasc Anesth. 2007; 21(4):497-501. DOI: 10.1053/j.jvca.2006.05.011. View

14.

Chalkiadis G, Goucke C . Depth of central venous catheter insertion in adults: an audit and assessment of a technique to improve tip position. Anaesth Intensive Care. 1998; 26(1):61-6. DOI: 10.1177/0310057X9802600109. View

15.

Vesely T . Central venous catheter tip position: a continuing controversy. J Vasc Interv Radiol. 2003; 14(5):527-34. DOI: 10.1097/01.rvi.0000071097.76348.72. View

16.

Albrecht K, Nave H, Breitmeier D, Panning B, Troger H . Applied anatomy of the superior vena cava-the carina as a landmark to guide central venous catheter placement. Br J Anaesth. 2003; 92(1):75-7. DOI: 10.1093/bja/aeh013. View

17.

Peres P . Positioning central venous catheters--a prospective survey. Anaesth Intensive Care. 1990; 18(4):536-9. DOI: 10.1177/0310057X9001800422. View