Appropriate Length and Position of the Central Venous Catheter Insertion via Right Internal Jugular Vein in Children.

Design: Observational study. Setting: Tertiary University Hospital. Participants/patients: Patients, aged 6 days to 19 years, who underwent contrast enhancement computerized tomography imaging of the thorax (CT-thorax). Main outcome measures: We measured three lengths consisting of length A in axial plane at the level of the lower border of the 6th C-spine from the skin to RIJV at its mid lumen, length B and C in sagittal plane from the RIJV at the level of the lower of the 6th C-spine to the superior vena cava (SVC) at carina and from carina to SVC-right atrium junction, respectively. Lengths A plus B represented the length of CVC where the tip was expected in the SVC at carina (CVCcarina). Lengths A plus B and C represented the length of CVC when the tip was expected in the SVC at SVCright atrium junction (CVCSVC-RA). Results: One hundred and sixty-five cases with mean age of 8.1 ± 4.7 years were reviewed. The CVCSVC-RA and CVC carina were significantly correlated with age and body surface area (BSA). Using multiple regression analysis, CVCSVC-RA (cm) was equal to 6.4 + 2.8[BSA (m2)] + 0.022[age (month)] and CVCcasina (cm) equal to 4.9 +2.7[BSA (m2)] +0.013[age (month)] (Adjusted Rsquared 0.7275, 0.7140). Conclusions: We recommended the appropriate CVC length via RIJV approach should be between these two calculated lengths and the CVC length in each age according to the BSA.

Clinical application of ultrasound guided percutaneous right internal jugular vein catheterization in hemodialysis / 中国介入影像与治疗学

ObjectiveTo explore the clinical application of ultrasound guided percutaneous right internal jugular vein catheterization in hemodialysis,and to analyze the methods,precautions and prevention of complications of puncture.MethodsTotally 297 patients of chronic renal insufficiency with uremia underwent ultrasound guided percutaneous right internal jugular vein catheterization according to technical points of increasing the success rate of puncture.ResultsThe total successful rate of puncture was 100％.The first puncture succeeded in 244 patients (244/297,82.15 ％),the second in 30 (30/297,10.10％) and the third in 23 (23/297,7.74％) patients.The complication rate was 15.15％ (45/297).Poor adherence of catheter led to cited blood difficultly and inadequate flow in 31 patients.ConclusionUltrasound guidance can greatly improve the success rate of puncture in percutaneous right internal jugular vein catheterization,while reduce the incidence of complications.