Simple formulas to determine optimal subclavian central venous catheter tip placement in infants and children

Andrea Stroud, Jill Zalieckas, Corinne Tan, Sarah Tracy, David Zurakowski, David P. Mooney

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background/Purpose Optimal central venous catheter (CVC) tip location is necessary to decrease the incidence of complications related to their use. We sought to create a practical method to reliably predict the length of catheter to insert into the subclavian vein during CVC placement in children. Methods We performed a retrospective review of 727 chest radiographs of children who underwent either left or right subclavian CVC placement. We measured the distance from the subclavian entry site to the to the right atrium/superior vena cava (RA/SVC) junction, following the catheter's course. We analyzed the relationship between that length and patient characteristics, including: age, gender, height, weight and body surface area (BSA). Results Two derived formulas using the BSA best correlated with the optimal subclavian CVC length. For the left subclavian vein approach, the optimal catheter length was 6.5*BSA + 7 cm, and for the right subclavian vein approach it was 5*BSA + 6. The use of these formulas correlated in CVC tip placement in a clinically proper location in 92.9% of smaller children and in 95.7% of larger children. Conclusion The optimal length of central venous catheter to insert into the subclavian vein may be determined through the use of a simple formula using the BSA.

Original languageEnglish (US)
Pages (from-to)1109-1112
Number of pages4
JournalJournal of pediatric surgery
Volume49
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • Central venous catheter
  • Complication
  • Pediatric
  • Subclavian vein
  • Technique

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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