article information

Anesthesiology and Pain Medicine: Vol.2, issue 3; 111-114
published online: January 1, 2013
article type: Research Article
received: August 2, 2012
accepted: October 6, 2012
DOI: https://doi.org/10.5812/aapm.7557
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Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults

authors:

avatar Prerana N. Shah 1 , * , avatar Deepa Kane 1 , avatar Jithesh Appukutty 1

Department of Anaesthesiology, Seth GSMC and KEM Hospital, Parel, Mumbai, pps@kem.edu, India

how to cite: Shah P N, Kane D, Appukutty J. Depth of Central Venous Catheterization by Intracardiac Electrocardiogram in Adults. Anesth Pain Med. 2013;2(3): 111-114. https://doi.org/10.5812/aapm.7557.

Abstract

Background:

Central venous catheterization is done frequently in cardiac surgery and intensive care settings. Faulty positioning of the catheter can cause many complications.

Objectives:

The aim of our study was to study the average depth of insertion and formulate a general guideline through the right internal jugular vein (IJV).

Patients and Methods:

The right IJV was cannulated over a period of four months and catheter tip positioning was guided by means of an intracardiac electrocardiogram (ECG). Insertion depth was registered at the position of maximum P wave amplitude and the catheter was fixed after withdrawing 2 cm. Pearsons correlation coefficient was calculated to categorize any relationship between plots of distance versus patients height, and regression lines and equations were also calculated. Bland-Altman analysis of data was done to compare the old formulae with our derived formulae.

Results:

A total of 155 adult patients were studied. Distances measured were found to be highly correlated with a patients height, followed by body surface area (BSA) and weight. For right IJV cannulation in valvular surgeries in adults, the depth of insertion (cm) was (height in cm / 15) + 2 1.58 (SD) and in non-valvular surgeries in adults, it was (height in cm/15) + 1.4 1.47 (SD). The bias was very small when the new formulae were compared to the existing formulae.

Conclusions:

The devised formulae predicted the required depth of catheters thereby reducing the possibility of complications and need for radiographic confirmation.

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