Depth of Central Venous Catheterization: An Audit of Practice in a Cardiac Surgical Unit
Open Access
- 1 June 1994
- journal article
- other
- Published by SAGE Publications in Anaesthesia and Intensive Care
- Vol. 22 (3), 267-271
- https://doi.org/10.1177/0310057x9402200303
Abstract
Central venous catheter (CVC) depth relative to the cephalic limit of the pericardial reflection (CLPR) was assessed retrospectively in 100 adult patients from chest radiographs taken after admission to the intensive care unit. A well known landmark proved to be considerably influenced by parallax; therefore we located the CLPR by a new landmark, the junction of the azygos vein and the superior vena cava, identified by the angle of the right main bronchus and the trachea. The majority (58) of CVC tips lay below the pericardial reflection on the first chest radiograph (CXR). Of these only two had been corrected by the time of the next routine CXR. No case of cardiac tamponade secondary to erosion by a CVC could be remembered, or identified from records of routine departmental audit meetings, for the last ten years. Nevertheless, reported incidents of this complication have often been fatal and vigilance is necessary in any patient with a CVC.Keywords
This publication has 8 references indexed in Scilit:
- Accurate placement of central venous cathetersCritical Care Medicine, 1993
- Placement and Complications of Monitoring CathetersSurgical Clinics of North America, 1991
- Positioning Central Venous Catheters – A Prospective SurveyAnaesthesia and Intensive Care, 1990
- Central Venous Catheter Vascular ErosionsAnnals of Surgery, 1989
- Central Vein CatheterizationArchives of Internal Medicine, 1986
- Invited commentaryWorld Journal of Surgery, 1982
- Pericardial tamponade caused by central venous cathetersWorld Journal of Surgery, 1982
- Cardiac tamponade and central venous catheters.BMJ, 1975