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J Korean Soc Emerg Med > Volume 18(5); 2007 > Article
Journal of The Korean Society of Emergency Medicine 2007;18(5): 387-393.
Optimal Length of Central Venous Catheterization Using 3-Dimensional Multi-Detector Row Computed Tomography
Ki Jeong Hong, Jung Ho Shin, Hyun Soo Park, Seong Chun Kim, Gil Joon Suh, Joong Eui Rhee
1Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Korea.
2Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Korea. shinjho@korea.ac.kr
ABSTRACT
PURPOSE:
Knowing the optimal length of central venous catheterization is important in order to prevent complications provoked by inappropriate placement of the tip of central venous catheter. We evaluated the optimal lengths of central venous catheterization using 3-Dimensional Multi- Detector Row Computed Tomography (MDCT).
METHODS:
Between May 2005 and September 2005, we prospectively enrolled 122 consecutive patients who underwent elective chest MDCT. We reconstructed 3-dimensional MDCT images of the right internal jugular vein, right subclavian vein, left internal jugular vein, left subclavian vein and the superior vena cava/right atrium (SVC/RA) junction. In 3-dimensional images, we measured the distance from the puncture site of catheterization to the SVC/RA junction. In addition, we analyzed the correlation of the length of central vein to demographic findings, including patients' height, weight, body mass index, and body surface area (BSA). By regression modeling, we derived formulas to calculate the optimal lengths for central venous catheterization.
RESULTS:
The optimal lengths of central venous catheterization via the right internal jugular vein, right subclavian vein, left internal jugular vein, and left subclavian vein were 12.9+/-1.5 cm, 14.0+/-1.5 cm, 15.9+/-1.9 cm, and 17.9+/-1.4 cm, respectively. The optimal length of right subclavian catheterization correlated significantly with body weight and BSA (p<0.01). The optimal length of left internal jugular approach correlated well with height (p<0.01), body weight, BMI, and BSA (p<0.005).
CONCLUSION:
The optimal lengths of central venous catheter were measured by 3-dimensional MDCT and correlated with demographic findings. By regression modeling, we developed formulas to predict the optimal length of central venous catheterization using based on demographic findings.
Key words: Central Venous Catheterization, Computed tomography, Subclavian vein, Jugular veins
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