Revista Cubana de Anestesiología y Reanimación
versão On-line ISSN 1726-6718
LIMA AGUIAR, Junior M. et al. Distance measured to introduce a central-venous catheter in internal jugular vein via right anterior in children. Rev cuba anestesiol reanim [online]. 2011, vol.10, n.2, pp. 144-151. ISSN 1726-6718.
Introduction: The appropriate placement of distal end of the central venous catheter is very important for the achievement of hemodynamic information. Objective: To determine the distance measured from the skin up to atriocaval joint according to age, weight and height and to identify the complications. Method: In an observational, descriptive, analytical and prospective study were included 72 children programmed for elective cardiac surgery previous informed consent and the approval of Ethical Committee. After induction of general anesthesia a 3-5 cm interscapular wedge was placed, head was in central and outstretched position, Trendelemburg position of 15°. At cricoids cartilage level the right carotid pulse was felt and lateral to it the internal jugular vein was punctured. Trocar was directed with an angle of 45° towards the ipsilateral breast introducing the catheter using the classic Seldinger technique measuring the distance in centimeters from the insertion site up to sternoclavicular joint to confirm the position en the atriocaval joint of the catheter during the opening of the right atrium and to determine the distance of the introduced catheter according to its scale. Complications were registered at arrival of patient to intensive therapy unit obtaining anteroposterior thorax radiography. Results: In patients aged under 1 and weighing 10kg it is necessary to introduce 6 cm, from 1 to 10 years and weighing 11 and 50 kg the distance is of 6 cm and for those over 10 years and weighing 50kg are needed only 10 cm with a low rate of complications. Conclusions: Distance to introduce the catheter into the superior vena cava was determined achieving a low rate of complications.
Palavras-chave : Central venous catheter; internal jugular vein; right anterior route; distance from skin to atriocaval joint.