Author(s): Mojtaba Mansouri1, Gholamreza Massoumi1, Ali Akbar Shateri
Central venous catheterization is usually performed during
major surgeries for central venous pressure assessment and fluid therapy. Va
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riety of techniques is employed in central venous catheterization but the
information about pediatrics usage is limited. In this study we compared the
electrocardiographic technique with landmark one for central venous catheter
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ization.
Materials and Methods:
This is a cross-sectional study in 75 patients
who underwent central venous catheterization for elective cardiovascular tho
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racic surgery. In the first step, the location of catheterization was estimated
based on body surface landmarks. Then catheterization was done using elec
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trocardiography. Then with cardio-surgeons aid, during open cardiac surgery,
the catheter tip location was found (gold standard). Finally, chest X-ray was
taken and catheter place based on radiological markers was recorded.
Results:
In this study 75 children with age under 18 years were included. The gender
distribution was 42.7% females and 57.3% males. The mean depth of central
venous catheter in gold standard method was 7.5±1.35cm. Significant associ
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ation between central venous catheter placement in gold standard technique
and both landmark and electrocardiographic was seen (P-value<0.001; r=0.94
and P-value<0.001; r=0.77). Logistic regression showed a significant asso
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ciation between weight and placement of catheter tip in landmark technique
(P-value=0.038) as the following formula (Depth of central venous catheter=
5.33+0.07*weight).
Conclusion:
Our study showed that the use of electrocar
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diographic for central venous catheterization considering carina-to-tip as ref
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erence was superior to the landmark. In addition, the correct position of cathe
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ter tip was affected by weight but not by height based on landmark technique