J Korean Soc Emerg Med.  2010 Feb;21(1):44-47.

The Optimal Length of a CVC Inserted via the Right Internal Jugular Vein during Computed Tomography

• Ko BS
• You SM
• Lee YS
• Lee JH
• Oh BJ
• Kim W
• Lim KS
• Kim WY

Abstract

PURPOSE
The aim of this study was to investigate the optimal length of a central venous catheter (CVC) inserted through the right internal jugular vein
METHODS
During a 4-month period, we prospectively studied 374 patients who required a CVC. We enrolled 39 patients who underwent chest computed tomography (CT). The skin was punctured at the anterior border of the sternocleidomastoid muscle and at mid-distance between the angle of the mandible and the sternoclavicular junction. We measured the distance from catheter insertion to the superior vena cava/right atrium (SVC/RA) junction and calculated the recommended depth.
RESULTS
The optimal length of a CVC inserted via the right internal jugular vein was 15 cm, this was based on the mean distance from the CVC insertion point to the distal SVC. By using these guidelines, the initial placement of a CVC in the distal SVC was more accurate than using other formulas (92.3% vs. 76.9%).
CONCLUSION
To increase the likelihood of optimal tip location within the SVC on the first attempt and elimination of reposition, we suggest using the recommended depth instead of a formula to guide catheter placement.

Keyword

Jugular vein; Central venous catheterization; X-ray Computed tomography

MeSH Terms

Catheterization, Central Venous
Catheters
Central Venous Catheters
Humans
Jugular Veins
Mandible
Muscles
Prospective Studies
Skin
Thorax
Tomography, X-Ray Computed