Abstract
Purpose
Placement of a central venous catheter (CVC) is the most commonly performed pediatric procedure. This study aims to develop simple formulas to calculate intravascular length of CVCs prior to insertion to minimize reliance on fluoroscopic and radiographic imaging, which may not be uniformly available.
Methods
We performed a single-institution, retrospective review of 115 pediatric patients who received both CVC placement and computed tomography (CT) imaging of the chest within 3 months of the procedure. Using measurements from the CT imaging, formulas calculating the length of the intravascular component of the CVC based on height and insertion laterality were developed and compared to previously published formulas. These formulas were then trialed prospectively to validate reliability and application.
Results
Formulas were developed for right-sided and left subclavian insertion. The right-side formula accurately predicted CVC length in 52.6% of patients, compared to 47.4% by the Andropoulos formula. The left subclavian formula accurately estimated 62.5%, compared to 34.5% by the Stroud formula.
Conclusions
The optimal intravascular length of central venous catheters may be determined by simple formulas based on patient height and insertion site.
Level of evidence
III.
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Funding
This research was supported in part by The American Lebanese Syrian Associated Charities/St. Jude Children’s Research Hospital.
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All authors contributed to the study conception and design. Data collection and analysis were performed by AR, OG-Q, PS, ZL, XW, HA. Original draft preparation: AR, OG-Q, HA. Review and editing: AR, OG-Q, XW, ZL, HP, AD, LT, AM, HA. Supervision: AD, LT, AM, HA.
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Ross, A.B., Gomez-Quevedo, O., Sutthatarn, P. et al. A CT scan-based formula for predicting central venous catheter length in pediatric patients. Pediatr Surg Int 38, 1335–1340 (2022). https://doi.org/10.1007/s00383-022-05165-4
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DOI: https://doi.org/10.1007/s00383-022-05165-4