Vinay M, Tejesh C A
Department of Anesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Department of Anesthesiology, MS Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
Saudi J Anaesth. 2016 Jul-Sep;10(3):255-8. doi: 10.4103/1658-354X.174904.
Central venous catheters (CVCs) are inserted in many critically ill patients, but there is no gold standard in estimating their approximate depth of insertion. Many techniques have been described in literature. In this study, we compare the topographic method with the standard formula technique.
260 patients, in whom central venous catheterization was warranted, were randomly assigned to either topographic method or formula method (130 in each group). The position of the CVC tip in relation to carina was measured on a postprocedure chest X-ray. The primary endpoint was the need for catheter repositioning.
The majority of the CVCs tips positioned by the formula method were situated below the carina, and 68% of these catheters required repositioning after obtaining postprocedure chest X-ray (P < 0.001).
The topographic method is superior to formula approach in estimating the depth of insertion of right internal jugular CVCs.
许多重症患者需要插入中心静脉导管（CVC），但在估计其大致插入深度方面尚无金标准。文献中描述了许多技术。在本研究中，我们将体表定位法与标准公式法进行比较。
260例需要进行中心静脉置管的患者被随机分为体表定位法组或公式法组（每组130例）。术后胸部X线片测量CVC尖端相对于隆突的位置。主要终点是导管重新定位的必要性。
公式法定位的大多数CVC尖端位于隆突下方，其中68%的导管在术后胸部X线检查后需要重新定位（P<0.001）。
在估计右颈内静脉CVC的插入深度方面，体表定位法优于公式法。
