The Optimal Depth of Central Venous Catheteby Using Transesophageal Echocardiographyfor Pediatric Patients

다국어 초록 (Multilingual Abstract)

Background: Incorrect positioning of central venous catheter leads to serious complications. To prevent these complications, catheter tip should be at the superior vena cava and right atrial junction.
Methods: We studied 60 right internal jugular catheterizations in infants and children undergoing surgery for congenital heart disease. To confirm the optimal depth of central venous catheter, we measured the distance from the skin puncture site to subclavian vein-right atrial junction using transesophageal echocardiography.
Results: The measured distance highly correlated with the patient height. Based on these data, following guideline could avoid intra-atrial placement in 94% of the time: optimal depth of insertion (cm) = 2.5 + (0.06 × height).
Conclusions: We postulate that initial using a simple practical guideline could prevent malposition of central venous catheter.

참고문헌 (Reference)

1 "The optimal length of insertion of central venous catheters for pediatric patients" 93 : 883-6, 2001

2 "Positioning internal jugular venous catheters using the right third intercostal space in children" 47 : 1284-6, 2003

3 "Optimal placement of the CVC catheter in pediatric cardiac patients" 42 : 479-82, 1995

4 "Neck vein catheters and pericardial tamponade" 52 : 868-71, 1973

5 "MRI of central venous anatomy:implications for central venous catheter insertion" 114 : 820-6, 1998

6 "How much guidewire is too much Direct measurement of the distance from subclavian and internal jugular vein access sites to the superior vena cava-atrial junction during central venous catheter placement" 138-42, 2000

7 "Fatal cardiac tamponade and other mechanical complications of central venous catheters" 62 : 6-10, 1975

8 "Central venous catheter tip position:a continuing controversy" 14 : 527-34, 2003

9 "Cardiac tamponade from central venous catheters" 50 : 249-52, 1979

10 "Anesthesia" Philadelphia,Churchill Livingstone 1144-5, 2000

11 "Accurate central venous port-A catheter placement:intravenous electrocardiography and surface landmark techniques compared by using transesophageal echocardiography" 98 : 910-4, 2004

12 "A controlled study of transesophageal echocardiography to guide central venous catheter placement in congenital heart surgery patients" 89 : 65-70, 1999