Transoesophageal echocardiographic evaluation of central venous catheter positioning using Peres’ formula or a radiological landmark-based approach: a prospective randomized single-centre study

Ahn, Jung Hwan; Kim, I.S.; Yang, Jun; Lee, I.G.; Seo, Dong-Ho; Kim, S.P.

doi:10.1093/bja/aew430

Cited by 23 publications

(55 citation statements)

References 31 publications

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“…The authors demonstrated that by subtracting 0.5 cm from the depth derived from EL, the CVC tip could be reliably placed near the level of the carina in children aged under 5 years old . However, placing the CVC at the carina would result in positioning it in the middle part of the SVC and would be difficult to visualize by TEE …”

Section: Discussionmentioning

confidence: 99%

“…Our study illustrated that the mean (SD) distance from the carina‐to‐SVC‐RAJ was 1.25 (0.94) cm. Ahn et al found that the mean (SD) distance of the carina‐to‐SVC‐RAJ was 2.6 (1.1) cm in adults. They considered a minimal distance of the carina‐to‐SVC‐RAJ was 1.5 cm, added to distance AB and distance R to be the distance of RL.…”

Section: Discussionmentioning

confidence: 99%

“…The sample size calculation was determined from literature data . The proportion of an optimal CVC position for the RL was 0.90, while the estimated proportion of an optimal CVC position for the EL was 0.80.…”

Section: Methodsmentioning

confidence: 99%

“…The radiological landmark (RL) is a measurement of the distance of the sternal head of the right clavicle to the carina from the preoperative CXR combined with the patient's anatomical distance. There is evidence that the RL is accurate in the location of the CVC tip from the skin insertion point to the SVC‐RAJ in adults . Both the EL and RL are attractive practical noninvasive methods to guide the CVC depth placement.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of the external anatomical landmark and the radiological landmark for obtaining the optimal depth of a right internal jugular venous catheter in pediatric cardiac patients

Samerchua

Kongwatmai

Boonsri

et al. 2020

Pediatric Anesthesia

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Background:The external anatomical landmark and the radiological landmark have been introduced to provide estimation of the depth of right internal jugular venous catheter during insertion. Aims:This study aimed to compare the accuracy, agreement, and reliability of the external anatomical landmark and the radiological landmark, confirmation being by transesophageal echocardiography.Methods: This prospective observational study was conducted in children ages 1-15 years. The catheter was placed at the superior vena cava and the right atrium junction guided by transesophageal echocardiography. The catheter depth derived from the transesophageal echocardiography, the external anatomical landmark, and the radiological landmark was recorded. The optimal zone of the catheter tip was 5 mm below and 10 mm above the superior vena cava and the right atrium junction.Accuracy was assessed by the difference between the transesophageal echocardiography and the external anatomical landmark or the radiological landmark. Agreement with Bland-Altman plots and correlation were tested.Results: Eighty participants, median age of 3 years, were enrolled. The median (IQR) differences between the depth of the transesophageal echocardiography and the external anatomical landmark or the radiological landmark were 0.30 (0, 0.70) and 0.10 (−0.20, 0.90) cm, respectively. Bland-Altman plots demonstrated good agreement between the depths. The catheter tips were located in the optimal zone more frequently with the external anatomical landmark than the radiological landmark (94.7% vs 64.5%). The external anatomical landmark showed a stronger correlation to transesophageal echocardiography than the radiological landmark (r = .95 vs .83). Conclusion:Both the external anatomical landmark and the radiological landmark enabled accurate estimation of the central venous catheter depth close to the superior vena cava and the right atrium junction. The external anatomical landmark is of more potential use than the radiological landmark in clinical practice. | 491 SAMERCHUA Et Al.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Comparison of the external anatomical landmark and the radiological landmark for obtaining the optimal depth of a right internal jugular venous catheter in pediatric cardiac patients

Samerchua

Kongwatmai

Boonsri

et al. 2020

Pediatric Anesthesia

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“…However, people of the same height can have different body habitus that affect the corresponding fixed catheter depth. Many studies suggested that the optimal central line depth was significantly related to the central line curvature within the human body. In this study, a height and a body surface measurement (D) are included in the prediction equation, which is further individualized and useful for wide promotion.…”

Section: Discussionmentioning

confidence: 99%

Determination and prediction of the appropriate depth of right internal jugular vein catheterization via the middle approach in adults using transesophageal echocardiography

Sun

Feng

2019

Echocardiography

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Purpose The appropriate depth of right internal jugular venous (RIJV) catheterization is still under debated. In this study, transesophageal echocardiography (TEE) is used to develop a prediction formula for fixed RIJV catheter depth. Methods Eighty patients with indications for intraoperative TEE and central line placement were enrolled. After intubation, a RIJV catheter was inserted via the middle approach using the Seldinger technique. When the J‐tip of the guide wire appeared at the junction of the superior vena cava and the right atrium under TEE guidance, the guide wire was pulled back by approximately 2‐3 cm, until its tip was out of the pericardial fold. This depth was regarded as the insertion depth of the central venous catheter. Body landmark distance was measured, and the prediction formula was generated. Results The mean central line depth after TEE‐guided placement was 15.1 ± 1.7 cm. The prediction formula developed is as follows: Insertion depth = (Height ÷ 20) + (D ÷ 2), where D equals the distance from the insertion point to the sternal angle via the right sternoclavicular joint (r = 0.595, r2 = 0.354, P < 0.01). Conclusions TEE is an effective method for determining the appropriate insertion depth for an RIJV catheter. The prediction formula can be used as a reference for future RIJV catheterizations via the middle approach.

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Intracardiac Masses, Devices, and Foreign Bodies

Gelfenbeyn

Choi

2022

Essential Echocardiography

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Transoesophageal echocardiographic evaluation of central venous catheter positioning using Peres’ formula or a radiological landmark-based approach: a prospective randomized single-centre study

Abstract: Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp KCT0001937.

Cited by 23 publications

References 31 publications

A Comparison of the external anatomical landmark and the radiological landmark for obtaining the optimal depth of a right internal jugular venous catheter in pediatric cardiac patients

A Comparison of the external anatomical landmark and the radiological landmark for obtaining the optimal depth of a right internal jugular venous catheter in pediatric cardiac patients

Determination and prediction of the appropriate depth of right internal jugular vein catheterization via the middle approach in adults using transesophageal echocardiography

Intracardiac Masses, Devices, and Foreign Bodies

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