Abstract:
Background: Central venous catheterization is a vital procedure for volume resuscitation, infusion of drugs, and for central venous pressure monitoring in the perioperative period and intensive care unit (ICU). It is associated with position-related complications like arrhythmia’s, thrombosis, tamponade, etc. Several methods are used to calculate the catheter insertion depth so as to prevent these position-related complications.
Objective: To compare Peres’ formula and radiological landmark formula for central venous catheter insertion depth through right internal jugular vein (IJV) by the anterior approach.
Materials and methods: A total of 102 patients posted for elective cardiac surgery were selected and divided into two equal groups-Peres’ group (group P) and radiological landmark group (group R). Central venous catheterization of right IJV was done under ultrasound (USG) guidance. In group P, central venous catheter insertion depth was calculated as height (cm)/10. In group R, central venous catheter insertion depth was calculated by adding the distances from the puncture point to the right sternoclavicular joint and on chest X-ray the distance from the right sternoclavicular joint to carina. After insertion, the catheter tip position was confirmed using transesophageal echocardiography (TEE) in both the groups.
Results: About 49% of the catheters in group P and 74.5% in group R were positioned optimally as confirmed by TEE, which was statistically significant. No complications were observed in both the groups.
Conclusion: Radiological landmark formula is superior to Peres’ formula for measuring optimal depth of insertion of right internal jugular venous catheter.
Reference:
Manudeep AR, Manjula BP, Dinesh Kumar US. Comparison of Peres’ Formula and Radiological Landmark Formula for Optimal Depth of Insertion of Right Internal Jugular Venous Catheters. Indian J Crit Care Med. 2020;24(7):527-530. doi:10.5005/jp-journals-10071-23478