Clinical trial NCT05176886: Correct Tip Position of Central Venous Catheters
Official title: Assessment of the Correct Tip Position of Central Venous Catheters, Inserted Using Patient's Height Formula
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Central Venous Catheter
Internal Jugular Vein
Radiography
Subclavian Vein Injury
Keywords: central venous catheter insertion
Peres' formula
correct tip position
carina
Lead sponsor: Bozyaka Training and Research Hospital
Sponsor class: OTHER
First posted: 2022-01-04
Enrollment: 300
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients in intensive care unit and operating room who require a central venous catheter (right or left-sided) will be enrolled for the study.

Brief summary: Patients, ages between 18-70 years, who require central venous catheter will be enrolled for the study. Central venous catheter will be inserted using patient's height formula by Seldinger technique. Anterioposterior chest radiography will be used to assess the correct tip position. Catheters that are below the carina more than 1 cm, will be pulled back for repositioning. Catheters that are above the carina more than 1 cm, will be changed by another catheter. The investigators aim to evaluate the formula for correct tip positioning for central venous catheters

Detailed description: Central venous catheters are used for fluid infusion, nutrition, blood transfusion, hemodynamic monitorization in both intensive care unit and operating room. The superior vena cava and right atrium (SVC-RA) junction is considered the optimal position for central venous catheter tip. Carina corresponds to the SVC-RA junction on chest radiograph. Catheter tips, 1 cm above and 1 cm below the carina are considered as the correct position. 18-70 years old patients will be enrolled for the study. Central venous catheters will be inserted via internal jugular vein or subclavian vein using patient's height formula by Seldinger technique. Postprocedural (within 6 hours) chest radiograph will be used to evaluate the correct tip position from the Picture Archiving and Communication System. This formula was described by Peres. If the tip of the catheter is below the carina more than 1 cm, it will be pulled back for repositioning. If the tip of the catheter is above the carina more than 1 cm, another catheter will be inserted. The formula is height (cm)/10 for right internal jugular vein, height(cm)/10-2 for right subclavian vein, height(cm)/10+4 for left internal jugular vein and height(cm)/10+2 for left subclavian vein. Number of the correct and incorrect position of central venous catheter tips will be noted.

The investigators aim to evaluate the reliability and efficiency of Peres' formula for the correct tip position.

Eligibility criteria: Inclusion Criteria:

* Central venous catheterization of patients, ages between 18 and 70

Exclusion Criteria:

* Patient's refusal
* Pathology of carotid artery
* Anatomical deformity of the neck (scar, mass effect, multiple central venous catheterization)
* Chest deformities (pectus excavatum, pectus carinatum)

Primary outcomes:
measure: Number of correct position of central venous catheter tip
timeFrame: Within 6 hours after placement of central venous catheter
Secondary outcomes:
Other outcomes:
Locations:
city: Izmir
country: Turkey
facility: Izmir Bozyaka Training and Research Hospital
Study officials:
affiliation: Izmir Bozyaka Training and Research Hospital
name: Halide H Şahinkaya, MD
role: STUDY_CHAIR
affiliation: Izmir Bozyaka Training and Research Hospital
name: Mine Parlak, MD
role: STUDY_CHAIR
affiliation: Izmir Bozyaka Training and Research Hospital
name: Zeki T Tekgül, MD
role: STUDY_CHAIR
References:
citation: Joshi AM, Bhosale GP, Parikh GP, Shah VR. Optimal positioning of right-sided internal jugular venous catheters: comparison of intra-atrial electrocardiography versus Peres' formula. Indian J Crit Care Med. 2008 Jan;12(1):10-4. doi: 10.4103/0972-5229.40943.
citation: Kujur R, Rao MS, Mrinal M. How correct is the correct length for central venous catheter insertion. Indian J Crit Care Med. 2009 Jul-Sep;13(3):159-62. doi: 10.4103/0972-5229.58543.
citation: Salimi F, Imani MR, Ghasemi N, Keshavarzian A, Jazi AH. The mid-sternal length, a practical anatomical landmark for optimal positioning of long-term central venous catheters. J Res Med Sci. 2013 May;18(5):383-6.