Appropriate length and position of the central venous catheter insertion via right internal jugular vein in children

Indian Pediatr. 2013 Aug;50(8):749-52. doi: 10.1007/s13312-013-0217-7. Epub 2012 Dec 5.

Abstract

Design: Observational study.

Setting: Tertiary University Hospital.

Participants/patients: Patients, aged 6 days to 19 years, who underwent contrast enhancement computerized tomography imaging of the thorax (CT-thorax).

Main outcome measures: We measured three lengths consisting of length A in axial plane at the level of the lower border of the 6th C-spine from the skin to RIJV at its mid lumen, length B and C in sagittal plane from the RIJV at the level of the lower of the 6th C-spine to the superior vena cava (SVC) at carina and from carina to SVC-right atrium junction, respectively. Lengths A plus B represented the length of CVC where the tip was expected in the SVC at carina (CVC(carina)). Lengths A plus B and C represented the length of CVC when the tip was expected in the SVC at SVC-right atrium junction (CVC(SVC-RA)).

Results: One hundred and sixty-five cases with mean age of 8.1 ± 4.7 years were reviewed. The CVC(SVC-RA) and CVC carina were significantly correlated with age and body surface area (BSA). Using multiple regression analysis, CVC(SVC-RA) (cm) was equal to 6.4 + 2.8[BSA (m2)] + 0.022[age (month)] and CVC(casina) (cm) equal to 4.9 +2.7[BSA (m2)] +0.013[age (month)] (Adjusted R-squared 0.7275, 0.7140).

Conclusions: We recommended the appropriate CVC length via RIJV approach should be between these two calculated lengths and the CVC length in each age according to the BSA.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Catheterization, Central Venous / instrumentation*
  • Catheterization, Central Venous / methods*
  • Central Venous Catheters*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Jugular Veins / diagnostic imaging
  • Jugular Veins / surgery*
  • Pediatrics / instrumentation*
  • Pediatrics / methods
  • Radiography
  • Tertiary Care Centers