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Anesth Analg 2005;101:1301-1303
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000180997.72988.FE

PEDIATRIC ANESTHESIA

The Optimal Depth of Central Venous Catheter for Infants Less Than 5 kg

Jin-Hee Kim, MD*, Chong-Sung Kim, MD{dagger}, Jae-Hyun Bahk, MD{dagger}, Kyung Joon Cha, PhD{ddagger}, Young-Sun Park, PhD{ddagger}, Young-Tae Jeon, MD{dagger}, and Sung-Hee Han, MD{dagger}

*Department of Anesthesiology, Seoul National University Bundang Hospital; {dagger}Department of Anesthesiology, Seoul National University Hospital; {ddagger}Laboratory of Statistical Information Analysis, Hanyang University, College of Natural Sciences, Seoul, Korea

Address correspondence and reprint requests to Sung- Hee Han, MD, Department of Anesthesiology and Pain Medicine, 300 Gumi-Dong, Bundang-Gu, Seongnam–Si, Gyoenggi-Do, 463–707, Korea. Address e-mail to noninvasive{at}snubh.org or noninvasive{at}hanmail.net.

To avoid fatal complications of central venous catheterization such as cardiac tamponade, the tip of the central venous catheter (CVC) should be placed outside of the cardiac chamber. To suggest a guideline for a proper depth of CVC in infants, we measured the distance from the skin puncture site to the junction between superior vena cava and right atrium (SVC-RA junction) by using transesophageal echocardiography (TEE). Fifty infants less than 5 kg undergoing surgery for congenital heart disease were enrolled in this prospective study. After the induction of general anesthesia, CVC was inserted via the right subclavian vein. After the tip of the CVC was placed at the SVC-RA junction using TEE guidance, the length of the CVC inserted beneath the skin was measured. The measured distance had a high correlation with the patient’s height, weight, and age (r = 0.88, 0.76, and 0.64, respectively). In infants smaller than 5 kg, the following guideline can avoid intraatrial placement of the CVC: a depth between 40 and 45 mm for infants 2.0–3.0 kg in weight, 45–50 mm for those 3.0–3.9 kg, and 50–55 mm for those more than 4.0 kg.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.