The optimal depth of central venous catheter for infants less than 5 kg.
To avoid fatal complications of central venous catheterization such as cardiac tamponade, the tip of the central venous catheter (CVC) should be placed outside of the cardiac chamber. To suggest a guideline for a proper depth of CVC in infants, we measured the distance from the skin puncture site to the junction between superior vena cava and right atrium (SVC-RA junction) by using transesophageal echocardiography (TEE). Fifty infants less than 5 kg undergoing surgery for congenital heart disease were enrolled in this prospective study. After the induction of general anesthesia, CVC was inserted via the right subclavian vein. After the tip of the CVC was placed at the SVC-RA junction using TEE guidance, the length of the CVC inserted beneath the skin was measured. The measured distance had a high correlation with the patient's height, weight, and age (r = 0.88, 0.76, and 0.64, respectively). In infants smaller than 5 kg, the following guideline can avoid intraatrial placement of the CVC: a depth between 40 and 45 mm for infants 2.0-3.0 kg in weight, 45-50 mm for those 3.0-3.9 kg, and 50-55 mm for those more than 4.0 kg.
Kim
Jin-Hee
JH
*Department of Anesthesiology, Seoul National University Bundang Hospital; †Department of Anesthesiology, Seoul National University Hospital; ‡Laboratory of Statistical Information Analysis, Hanyang University, College of Natural Sciences, Seoul, Korea.
Kim
Chong-Sung
CS
Bahk
Jae-Hyun
JH
Cha
Kyung Joon
KJ
Park
Young-Sun
YS
Jeon
Young-Tae
YT
Han
Sung-Hee
SH
D001835:Body Weight; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male