Survey of Central Venous Catheter Depth Using the Carina as a Radiologic Landmark in ICU Patients.
10.4097/kjae.2005.49.3.376
- Author:
Jin HUH
1
;
Seung Yeon YOO
;
Young Jin RO
;
Seong Won MIN
;
Jae Hyon BAHK
;
Jong Su KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Boramae Municipal Hospital, Seoul, Korea. amandla@empal.com
- Publication Type:Original Article
- Keywords:
carina;
central venous catheter;
chest X ray;
internal jugular vein;
PACS;
subclavian vein
- MeSH:
Body Weight;
Catheters;
Central Venous Catheters*;
Humans;
Intensive Care Units;
Jugular Veins;
Male;
Punctures;
Surveys and Questionnaires;
Skin;
Subclavian Vein;
Thorax
- From:Korean Journal of Anesthesiology
2005;49(3):376-380
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: There is no unique guideline as to how to determine the depth of a central venous catheter (CVC). In this study, we inspected the current practice of CVC placement and evaluated insertion depth using the carina as a radiologic landmark in intensive care unit (ICU) patients. METHODS: In 138 ICU patients with a CVC in the right subclavian (SCV group) or internal jugular vein (IJV group), a chest X ray was taken, and the radiographic vertical distance between the catheter tip and the carina level (D-CC) was measured in Picture Archiving and Communication System (PACS) view. The distance between the skin puncture site and the carina level (D-SC) was calculated by adding/subtracting D-CC to/from the actual CVC insertion length. In addition, we surveyed physicians using a questionnaire about the methods they used to determine CVC depth. RESULTS: Mean D-SC was 13.80 +/- 1.69 cm in the SCV group, 14.42 +/- 1.34 cm in the IJV group, but no correlation was found with any measured physical dimension. In males, D-SC was greater, but this difference was not statistically significant. Physicians determined required insertion depths using many different methods (e.g., height, sex......). CONCLUSIONS: Patient height, weight, body mass index (BMI), and sex were not found to be reliable for predicting a safe CVC length. We recommend that after CVC insertion, a chest X ray should be taken and the catheter tip repositioned if necessary to reduce catheter related fatal complications (e.g., cardiac tamponade).
