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J Korean Soc Emerg Med > Volume 21(1); 2010 > Article
Journal of The Korean Society of Emergency Medicine 2010;21(1): 44-47.
The Optimal Length of a CVC Inserted via the Right Internal Jugular Vein during Computed Tomography
Byuk Sung Ko, Seung Mok You, Youn Sun Lee, Jae Ho Lee, Bum Jin Oh, Won Kim, Kyoung Soo Lim, Won Young Kim
Department of Emergency Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. wonpia@yahoo.co.kr
The aim of this study was to investigate the optimal length of a central venous catheter (CVC) inserted through the right internal jugular vein
During a 4-month period, we prospectively studied 374 patients who required a CVC. We enrolled 39 patients who underwent chest computed tomography (CT). The skin was punctured at the anterior border of the sternocleidomastoid muscle and at mid-distance between the angle of the mandible and the sternoclavicular junction. We measured the distance from catheter insertion to the superior vena cava/right atrium (SVC/RA) junction and calculated the recommended depth.
The optimal length of a CVC inserted via the right internal jugular vein was 15 cm, this was based on the mean distance from the CVC insertion point to the distal SVC. By using these guidelines, the initial placement of a CVC in the distal SVC was more accurate than using other formulas (92.3% vs. 76.9%).
To increase the likelihood of optimal tip location within the SVC on the first attempt and elimination of reposition, we suggest using the recommended depth instead of a formula to guide catheter placement.
Key words: Jugular vein, Central venous catheterization, X-ray Computed tomography
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