Validation of a Proposed Equation for Calculation of the Optimal Depth of Central Venous Catheter Inserted via the Right Internal Jugular Vein using the Middle Approach in Adult Patients

Abstract Background A central venous catheter (CVC) is utilized for the monitoring of central venous pressure (CVP) and the administration of vasoactive drugs and fluids. Aim of the Work The aim of this study was to validate a proposed equation for evaluation of the optimal depth of central venous catheter inserted via the right internal jugular (IJV) vein using the middle approach in adult patients. Patients and Methods 40 adult patients scheduled for open cardiac surgery were enrolled in whom TEE monitoring is indicated or preferred. Results Postoperative CXR showed that none of the patients in whom CVC placement was guided by TEE had their CVC tip placed below the level of the carina. The hypothetical position of the CVC tip as guided with surface landmark-based formula would have been below the carina in 6 (15%) of patients. The corresponding percentages for the C-length method and Pere’s formula would have been 45% and 100% respectively. Conclusion The central venous catheter tip was evaluated with the TEE and we were able to verify the accuracy of the proposed equation that was introduced by regression analysis of the results they got by placing the CVC tips in the mid SVC based on surface landmarks.