[Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Baskıdaki Makaleler: TARD-32748

Comparative Study of Three Methods for Depth of Central Venous Catheter Placement in Children- An Observational Pilot Study

Vaishali Chaskar, Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Department of Anaesthesiology, Seth G.S. Medical college, K.E.M. hospital, Parel, Mumbai.

Objective: Central venous cannulation(CVC) of internal jugular vein is difficult in paediatric patients because of its small size and anatomic variations. Many studies have shown the accuracy of various formulae for depth of placement. The aim of this study was to assess the most reliable method for central venous catheter tip placement in Indian paediatric population
Methods: Sixty-nine patients in the age group from newborn to 12 years were divided in three groups for three published techniques for catheter tip placement. In Group E, catheter tip was placed at distance measured from entry point to sternal angle. In Group P, Peres formula and in Group H, TEE derived formula was used for catheter placement. Post procedure chest radiograph was done for all patients and tip position was recorded. Appropriate catheter tip position was considered just above or at the level of carina. Number of attempts and complications were recorded. Chi square test was used for statistical analysis.
Results: Out of 69 patients, percentage of patients having appropriate position of CVC tip was 65% in group P, 52% in group H and 91% in group E. Chi square test showed that the difference in the number of patients with appropriately positioned CVC tip among the three groups was statisticaly significant (P value- 0.0134) with intergroup analysis showing Group E to be superior.
Conclusion: Catheter tip placement by external distance or landmark technique is a more accurate method for catheter placement than the Peres and TEE based formulae in Indian paediatric population.

Keywords: Anatomic Landmark, central venous catheter, children

Sorumlu Yazar: Priyanka Pradeep Karnik, India

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