Correct Depth of Insertion of Right Internal Jugular Central Venous Catheters Based on External Landmarks: Avoiding the Right Atrium

Ezri, Tiberiu; Weisenberg, Marian; Sessler, Daniel I.; Berkenstadt, Haim; Elias, Sorin; Szmuk, Peter; Serour, Francis; Evron, Shmuel

doi:10.1053/j.jvca.2006.05.011

Cited by 41 publications

(25 citation statements)

References 21 publications

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“…The optimal catheter length was determined under fluoroscopic guidance by measuring the distance from the pocket for the TICVAP to the angle of the right main bronchus and trachea. Variable studies about the SVC-right atrium junction level on the chest radiograph [17,18] have been reported, but in our study, there were no late complications related to the catheter length.…”

Section: Discussioncontrasting

confidence: 60%

A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports

Seok

Kim

Cho

et al. 2014

Korean J Thorac Cardiovasc Surg

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BackgroundWhen managing patients who require repeated venous access, gaining a viable intravenous route has been problematic. To improve the situation, various studies on techniques for venous access have been conducted. The aim of this study is to evaluate the clinical results of complications following totally implanted central venous access port (TICVAP) insertion.MethodsA retrospective analysis was conducted on 163 patients, from December 2008 to March 2013. The occurrence of complications was studied in three separate periods of catheter use: the intraoperative period, postoperative period, and period during the treatment.ResultsA total of 165 cases of TICVAP insertions involving 156 patients were included in the final analysis. There were 35 complications (21%) overall. Among these, 31 cases of complications (19%) occurred during the treatment period and the other 4 cases were intraoperative and postoperative complications (2%). There were no statistically significant differences in age and gender of the patients between the two groups to be risk factors (p=0.147, p=0.08). Past history of chemotherapy, initial laboratory findings, and the locations of TICVAP insertion also showed no statistical significance as risk factors (p>0.05).ConclusionBecause the majority of complications occurred after port placement and during treatment, meticulous care and management and appropriate education are necessary when using TICVAPs.

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Section: Discussioncontrasting

confidence: 60%

A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports

Seok

Kim

Cho

et al. 2014

Korean J Thorac Cardiovasc Surg

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“…(4) In a prospective randomized study by Ezri T et al on 100 patients, for the comparison of CVC insertion by topographic landmark technique and predetermined length (15 cm) insertion, 98% of patients in landmark technique were found to have catheter tip positioned at right place on chest Xray. In this the author did not use TEE to check the position of catheter tip as in our study (5) Lee JH et al compared the accuracy of CVC tip localization between ECG-and landmark-guided catheterization and concluded that central venous catheterization via the right IJV, landmark guidance was comparable with ECG guidance with regard to CVC tip positioning in the superior vena cava (6) In a study by Myung-Chun Kim et al to determine whether the topographical measurement along the course of the central veins can estimate the approximate insertion depths of central venous catheters (CVC). The CVC locations could be predicted with a margin of error between 2.2 cm below the carina and 2.3 cm above the carina in 95% of patients (7) The above studies have done the IJV cannulation using different landmark techniques.…”

Section: Resultsmentioning

confidence: 99%

Bedside Prediction of Correct Length of Right Internal Jugular Venous Catheters Based on Anatomical Land Marks

Vs¹

2017

JMSCR

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“…[6814] It is also recommended that the catheter tip should lie in the long axis of the SVC without acute abutment to the vein wall. [34] It has been shown in the laboratory that an angle of the CVC tip to vessel wall of greater than 40° is more likely to lead to vessel wall perforation.…”

Section: Discussionmentioning

confidence: 99%

“…[34] It is also recommended that the catheter tip should lie in the long axis of the SVC, without acute abutment to the vein wall. [4] Various methods such as anatomical landmarks,[56] simple formulae,[7] right atrial electrocardiography[8–10] and echocardiography[11] have been used to ensure correct placement of the CVC tip.…”

Section: Introductionmentioning

confidence: 99%

How correct is the correct length for central venous catheter insertion

Kujur

Rao

Mrinal

2009

Indian Journal of Critical Care Medicine

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Background and Aim:Central venous catheters (CVC) are important in the management of critically ill patients. Incorrect positioning may lead to many serious complications. Chest radiograph is a convenient means of determining the correct position of the catheter tip. The present study was designed to evaluate the depth of CVC placed through the right and left internal jugular vein (IJV) in order to achieve optimum placement of the catheter tip.Materials and Methods:A total of 107 patients in whom CVCs were put through either the right or left IJV through a central approach were included in this prospective study. Catheter tip position was observed in the post procedure chest radiograph. It was considered correct if the tip was just below the carina in the left-sided catheters and just above carina in the right-sided catheters. The catheters were repositioned based on the chest radiographs. The catheter depth leading to optimum tip placement was noted.Results:In males, catheter repositioning was required in 13 of 58 patients (22.41%) in the right IJV catheters, whereas in 2 of 13 patients (15.38%) in the left IJV catheters. In females, repositioning was required in 12 of 25 patients (48%) in the right IJV catheters and 2 of 11 patients (18.18%) in the left IJV catheters. Repositioning rate was higher in females (14/36) compared with males (15/71), which was statistically significant (P = 0.05, 95% CI). Repositioning rates were significantly higher in females (12/25) as compared with males (13/58) in the right IJV catheters (P = 0.019, 95% CI).Conclusion:By cannulating the IJV through a central approach, the catheters can be fixed at a length of 12-13 cm in males and 11-12 cm in females in the right IJV and at a length of 13-14 cm in males and 12-13 cm in females in the left IJV in order to achieve correct positioning.

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Correct Depth of Insertion of Right Internal Jugular Central Venous Catheters Based on External Landmarks: Avoiding the Right Atrium

Cited by 41 publications

References 21 publications

A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports

A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports

Bedside Prediction of Correct Length of Right Internal Jugular Venous Catheters Based on Anatomical Land Marks

How correct is the correct length for central venous catheter insertion

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