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 SVC-right 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 (m(2))] + 0.022[age (month)] and CVCcasina (cm) equal to 4.9 +2.7[BSA (m(2))] +0.013[age (month)] (Adjusted R-squared 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.