Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults
Anesthesiology and Pain Medicine: 2 (3); 111-114
January 1, 2013
Article Type: Research Article
August 2, 2012
October 6, 2012
P N, Kane
J. Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults,
Anesth Pain Med.
Online ahead of Print
Central venous catheterization is done frequently in cardiac surgery and intensive care settings. Faulty positioning of the catheter can cause many complications.
The aim of our study was to study the average depth of insertion and formulate a general guideline through the right internal jugular vein (IJV).
Patients and Methods:
The right IJV was cannulated over a period of four months and catheter tip positioning was guided by means of an intracardiac electrocardiogram (ECG). Insertion depth was registered at the position of maximum P wave amplitude and the catheter was fixed after withdrawing 2 cm. Pearsons correlation coefficient was calculated to categorize any relationship between plots of distance versus patients height, and regression lines and equations were also calculated. Bland-Altman analysis of data was done to compare the old formulae with our derived formulae.
A total of 155 adult patients were studied. Distances measured were found to be highly correlated with a patients height, followed by body surface area (BSA) and weight. For right IJV cannulation in valvular surgeries in adults, the depth of insertion (cm) was (height in cm / 15) + 2 1.58 (SD) and in non-valvular surgeries in adults, it was (height in cm/15) + 1.4 1.47 (SD). The bias was very small when the new formulae were compared to the existing formulae.
The devised formulae predicted the required depth of catheters thereby reducing the possibility of complications and need for radiographic confirmation.
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