JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kim, J.-T. Articles by Kim, S.-D. Search for Related Content PubMed PubMed Citation Articles by Kim, J.-T. Articles by Kim, S.-D. Related Collections Critical Care Equipment

---

CRITICAL CARE AND TRAUMA

The Carina as a Useful Radiographic Landmark for Positioning the Intraaortic Balloon Pump

Jin-Tae Kim, MD, PhD^*, Jeong-Rim Lee, MD^*, Jae-Kwang Kim, MD^*, Seung Zhoo Yoon, MD, PhD^*, Yunseok Jeon, MD, PhD^*, Jae-Hyon Bahk, MD, PhD^*, Ki-Bong Kim, MD, PhD, Chong-Sung Kim, MD, PhD^*, Young-Jin Lim, MD, PhD^*, Hee-Soo Kim, MD, PhD^*, and Seong-Deok Kim, MD, PhD^*

From the Department of *Anesthesiology, Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University, Seoul, Korea.

Address correspondence and reprint requests to Seung Zhoo Yoon, MD, PhD, Department of Anesthesiology, College of Medicine, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea. Address e-mail to monday1031{at}yahoo.co.kr.

BACKGROUND: The aortic knob is thought to be the most useful radiographic landmark for the proper positioning of the intraaortic balloon pump (IABP) tip. However, this has not been studied formally. In this study we assessed whether the aortic knob is a reliable landmark for positioning the IABP and compared it with another potential landmark, the carina.

METHODS: We measured the distance from the top of the distal aortic arch (aortic knob) to the left subclavian artery (LSCA) on three-dimensional computed tomography angiography in 100 patients. The distance from the level of the LSCA origin to the level of the carina was also measured using three-dimensional computed tomography in 150 additional patients.

RESULTS: In 16% of the aortic knob study population, the LSCA to aortic knob distance was <0 cm or 0 cm. The median distance from the LSCA to the carina was 42 mm (range: 30–63 mm). In the carina study population, the origin of the LSCA was 35–55 mm above the carina in 95.3% of patients.

CONCLUSION: In 16% of patients, the IABP was too close to the LSCA origin when it was placed at the aortic knob, whereas positioning the IABP at 2 cm above the carina provided an adequate position for the IABP tip (1.5–3.5 cm distal to the origin of the LSCA) in 95.3% of patients. The carina may be a more reliable landmark for positioning the IABP than the aortic knob.

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