Correlation of Surface Landmarks Based Insertion Length of Right Subclavian Central Venous Catheter with Post Insertion Location of Catheter Tip
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 5, Issue 11
Abstract
Background: Subclavian central venous catheterisation (CVC) is done in critically ill patients requiring long-term central venous access. There is no gold standard for evaluating depth of insertion for catheter. In this study we correlated desired length of central venous catheter based on surface landmarks. Objectives: We conducted this study with two objectives, first is to estimate the appropriate insertion length of right subclavian central venous catheter using topographical measurements and other is to observe and quantitate the side effects which occur (if any) during central venous cannulation. Materials and Methods: After obtaining informed written consent from the patient’s relatives, fifty patient were enrolled for central venous catheterizations via the right subclavian vein (SCV). The infraclavicular approach was used. Topographical measurement based on surface landmarks (insertion point of the needle, through the ipsilateral clavicular notch to just below the insertion point of the second right costal cartilage to the manubriosternal joint) was performed by placing the catheter with its own curvature over the draped skin . The central venous catheter (CVCs) was inserted and secured to a depth determined topographically. The location of CVCs tip around the carina was observed on the post procedure chest X-ray. Results: The average insertion length in male was 13.2 cm and in female was 11.9 cm. In 95.1% of female patients and 89.6% of male patients, the tip was at or above the level of carina (≤1cm). It was considered correct if the tip was just above or at the level of the carina in the right-sided catheters. Conclusion: It is concluded from the study that CVC insertion depth can be estimated using the topographical measurement with the CVCs itself. Moreover, this method requires no additional cost and/or time-consuming procedures.
Authors and Affiliations
Jatin Kumar Khatodkar, Arvind Kumar Rathiya, Sudhakar Dwivedi
Keywords
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