title: Predicting the optimal depth of left-sided central venous catheters in children.
abstract: The aim of this study was to predict the optimal depth for insertion of a left-sided central venous catheter in children. Using 3D chest computed tomography angiography, we measured the distance from a point where the internal jugular vein is at the superior border of the clavicle, and from a point where the subclavian vein is inferior to the anterior border of the clavicle, to the junction of the superior vena cava and the right atrium in 257 children. Linear regression analysis revealed that the distances correlated with age, weight and height. Simple formulae for the depth of a central venous catheter via the left internal jugular vein (0.07 × height (cm)) and the left subclavian vein (0.08 × height (cm)) were developed to predict placement of the central venous catheter tip at the junction of the superior vena cava with the right atrium. Using these fomulae, the proportion of catheter tips predicted to be correctly located was 98.5% (95% CI 96.8-100%) and 94.0% (95% CI 90.8-97.3%), respectively.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Kim
authors.forename: C-H
authors.initials: CH
authors.lastname: Jeong
authors.forename: H-J
authors.initials: HJ
authors.lastname: Byon
authors.forename: H K
authors.initials: HK
authors.lastname: Shin
authors.forename: T J
authors.initials: TJ
authors.lastname: Yun
authors.forename: J-H
authors.initials: JH
authors.lastname: Lee
authors.forename: Y-H
authors.initials: YH
authors.lastname: Park
authors.forename: J-T
authors.initials: JT
authors.lastname: Kim
mesh_terms: D000792:Angiography; D001827:Body Height; D002405:Catheterization, Central Venous / Q000379:methods*; D057785:Catheters; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D007601:Jugular Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D013350:Subclavian Vein / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000033:anatomy & histology / Q000000981:diagnostic imaging