Evaluation of Surface Landmarks and C-Length as Predictors of the Depth of Right Internal Jugular Venous Catheter Insertion:

Abstract

entral venous catheterization (CVCs) is a standard clinical practice for infusion of fluids, blood products, or vasoactive drugs to the central circulation and to monitor central venous pressure (CVP) during perioperative periods in hemodynamically unstable patients and those undergoing major operations. The insertion of CVC can result in serious potentially life-threatening complications, including cardiac arrhythmia, vascular injury, hydrothorax, hemothorax, hydromediastinum, and cardiac tamponade. Different methods have been proposed to estimate the depth of CVC insertion. There is not yet a gold standard for the optimal depth for central venous catheters. Studies have used anatomical surface landamarks real time or postoperative chest X-rays using the carina as a landmark or trans-thoracic echocardiograms to indirectly assess the appropriate depth of catheter tips. New methods have been introduced recently to determine depth of catheter tip as transesophageal echocardiography other method by using radiographic landmark known as C-length. The aim of the current study was to evaluate the accuracy of the C-length or surface landmarks for placement of