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Indian Journal of Critical Care Medicine
Medknow Publications on behalf of the Indian Society of Critical Care Medicine
ISSN: 0972-5229
EISSN: 1998-359x
Vol. 12, No. 1, 2008, pp. 10-14
Bioline Code: cm08002
Full paper language: English
Document type: Review Article
Document available free of charge

Indian Journal of Critical Care Medicine, Vol. 12, No. 1, 2008, pp. 10-14

 en Optimal positioning of right-sided internal jugular venous catheters: Comparison of intra-atrial electrocardiography versus Peres' formula
Joshi, Anish M; Bhosale, Guruprasad P; Parikh, Geeta P & Shah, Veena R

Abstract

Central venous catheters are routinely placed in patients undergoing major surgeries where expected volume and hemodynamic disturbances are likely consequences. The incorrect positioning may give false central venous pressure (CVP) readings leading to incorrect volume replacement and other serious complications. 50 American Society of Anaesthesiologists grade II-IV patients aged 18-60 years were selected for right-sided internal jugular vein (IJV) catheterization using Seldinger′s technique. In group A, central venous catheterization was done under electrocardiography (ECG) guidance. In group B, the catheter was inserted blindly using Peres′ formula of "height (in cm)/10". The position of the tip of central venous catheter was confirmed radiologically by postoperative chest X-ray. 92% of patients in group A had radiologically correct positioning of catheter tip i.e. above the carina, while in group B 48% patients had over-insertion of the catheter in to the right atrium. Intra-atrial ECG technique to judge correct tip positioning is simple and economical. It can determine the exact position intraoperatively and can justify a delayed postoperative chest X-ray to confirm CVC line tip placement.

Keywords
Central venous catheterization, intra-atrial electrocardiography, Peres′ height formula

 
© Copyright 2008 Indian Journal of Critical Care Medicine.
Alternative site location: http://www.ijccm.org/

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