Abstract
Background
Knowledge of the optimal lengths for central venous catheterization prior to the procedure may lessen the need for repositioning and prevent vascular complications.
Objective
To establish the optimal lengths for non-tunneled central venous catheter insertion through the right and left internal jugular veins.
Materials and methods
We included 92 children who received US-guided central venous catheterization via right or left internal jugular veins in intensive care units. The calculated distance between the skin and carina was considered the optimal length for right and left internal jugular venous catheterization. Univariate and multivariate linear regression analyses was used to identify predictors.
Results
Age, height and weight showed significant correlations with optimal insertion lengths for right and left internal jugular vein approaches on univariate analysis, while height was the only significant independent predictor of optimal insertion length.
Conclusion
The optimal insertion lengths (cm) suggested by our data are, for the right internal jugular vein 0.034 × height (cm) + 3.173, and for the left 0.072 × height (cm) + 2.113.
Similar content being viewed by others
References
National Institute for Clinical Excellence (2002) Guidance on the use of ultrasound locating devices for placing central venous catheters. Technology Appraisal Guidance No. 49, September 2002, http://www.nice.org.uk/guidance/ta49/
Maecken T, Grau T (2007) Ultrasound imaging in vascular access. Crit Care Med 35:S178–S185
Trieschmann U, Cate UT, Sreeram N (2007) Central venous catheters in children and neonates — what is important? Images Paediatr Cardiol 9:1–8
Andropoulos DB, Bent ST, Skjonsby B et al (2001) The optimal length of insertion of central venous catheters for pediatric patients. Anesth Analg 93:883–886
Kim JH, Kim CS, Bahk JH et al (2005) The optimal depth of central venous catheter for infants less than 5 kg. Anesth Analg 10:1301–1303
Kim H, Jeong CH, Byon HJ et al (2013) Predicting the optimal depth of left-sided central venous catheters in children. Anaesthesia 68:1033–1037
Yoon SZ, Shin JH, Hahn S et al (2005) Usefulness of the carina as a radiographic landmark for central venous catheter placement in paediatric patients. Br J Anaesth 95:514–517
John SD, Swischuk LE (1995) Chest. In: Swischuk LE, John SD (eds) Differential diagnosis in pediatric radiology. Williams & Wilkins, Baltimore, pp 85–105
Stenzel JP, Green TP, Fuhrman BP et al (1989) Percutaneous central venous catheterization in a pediatric intensive care unit: a survival analysis of complications. Crit Care Med 17:984–988
De Jonge RC, Polderman KH, Gemke RJ (2005) Central venous catheter use in the pediatric patient: mechanical and infectious complications. Pediatr Crit Care Med 6:329–339
Bjarnason H, Lehmann S (1997) Central venous access. In: Castañeda-Zuñiga WR (ed) Interventional radiology. Williams & Wilkins, Baltimore, pp 941–965
Hsu JH, Wang CK, Chu KS et al (2006) Comparison of radiographic landmarks and the echocardiographic SVC/RA junction in the positioning of long-term central venous catheters. Acta Anaesthesiol Scand 50:731–735
Teele SA, Emani SM, Thiagarajan RR et al (2008) Catheters, wires, tubes and drains on postoperative radiographs of pediatric cardiac patients: the whys and wherefores. Pediatr Radiol 38:1041–1053, quiz 1151
Acknowledgments
We thank Allison Alley for language consultation and editing.
Conflicts of interest
None
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Choi, Y.H., Cheon, JE., Shin, S.H. et al. Optimal insertion lengths of right and left internal jugular central venous catheters in children. Pediatr Radiol 45, 1206–1211 (2015). https://doi.org/10.1007/s00247-015-3289-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-015-3289-9