Key result
Routine 15-cm right subclavian CVC depth does not differ significantly across patient height groups.
Why the study?
Positioning a central venous catheter tip within the pericardium has been associated with potentially lethal cardiac tamponade, motivating evaluation of the relationship between patient height and catheter depth.
What is the relationship between patient height and the depth of a central venous catheter?
Observational (n=262)
No
What is the relationship between patient height and the depth of a central venous catheter?
Answers are grounded in this paper and cite their sources.
The study aims to determine the relationship between patient height and CVC depth to potentially prevent lethal cardiac tamponade.
Background: Location of the tip of a central venous catheter (CVC) within the pericardium has been associated with potentially lethal cardiac tamponade.The purpose of this study was to show the relationship between the height of patients and the depth of CVC.Methods: We enrolled 262 adult patients into this study.All patients were divided to three groups according to the height; Group S, M and L. Central venous catheterization was performed through the right subclavian vein and the CVC was fixed at the depth of 15 cm from the skin.The distance between the CVC tips and the carina was measured by chest X-ray and was analyzed.Results: The mean (SD) tip position placed via the right subclavian vein was 0.04 (1.6) cm above the carina; Group S, 0.01 (1.8) above the carina, Group M, 0.16 (1.4) above the carina, and Group L, 0.16 (1.8) below the carina.CVC locations could be predicted with a margin of error between 3.1 cm below the carina and 3.2 cm above the carina in 95% of patients.There was no significance difference among the three groups.Conclusions: The relationship between the height of patient and the depth of CVC was low.Because many of the CVC tips were positioned below the carina regardless the height of patients on routine 15 cm-length method, it is recommended not to use the routine 15 cm method with right subclavian CVC placement as far as possible.
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Lee et al. (2011) conducted an observational in Adult surgical patients requiring right subclavian central venous catheterization (n=262). Patient height (Group S: 150-159.9 cm, Group M: 160-169.9 cm, Group L: ≥170 cm) with routine 15 cm right subclavian CVC fixation vs. Comparison across three height groups (Group S vs Group M vs Group L) was evaluated on Distance between the CVC tip and the carina on postoperative chest X-ray (and proportion outside the safe zone of 5 cm above to 1 cm below the carina) (95% CI -3.1 to 3.2, p=0.358). Routine 15-cm right subclavian CVC fixation showed no significant difference in tip depth relative to the carina across height groups.
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