Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults

AUTHORS

Prerana N. Shah 1 , * , Deepa Kane 1 , Jithesh Appukutty 1

1 Department of Anaesthesiology, Seth GSMC and KEM Hospital, Parel, Mumbai, [email protected], India

How to Cite: Shah P N, Kane D, Appukutty J. Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults, Anesth Pain Med. Online ahead of Print ; 2(3):111-114. doi: 10.5812/aapm.7557.

ARTICLE INFORMATION

Anesthesiology and Pain Medicine: 2 (3); 111-114
Published Online: January 1, 2013
Article Type: Research Article
Received: August 2, 2012
Accepted: October 6, 2012
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Abstract

Background: Central venous catheterization is done frequently in cardiac surgery and intensive care settings. Faulty positioning of the catheter can cause many complications.

Objectives: 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.

Results: 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.

Conclusions: The devised formulae predicted the required depth of catheters thereby reducing the possibility of complications and need for radiographic confirmation.

Keywords

Heart Catheterization Electrocardiography Veins

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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