Appropriate length and position of the central venous catheter insertion via right internal jugular vein in children.

DESIGN Observational study. SETTING Tertiary University Hospital. PARTICIPANTS/PATIENTS Patients, aged 6 days to 19 years, who underwent contrast enhancement computerized tomography imaging of the thorax (CT-thorax). MAIN OUTCOME MEASURES We measured three lengths consisting of length A in axial plane at the level of the lower border of the 6th C-spine from the skin to RIJV at its mid lumen, length B and C in sagittal plane from the RIJV at the level of the lower of the 6th C-spine to the superior vena cava (SVC) at carina and from carina to SVC-right atrium junction, respectively. Lengths A plus B represented the length of CVC where the tip was expected in the SVC at carina (CVC(carina)). Lengths A plus B and C represented the length of CVC when the tip was expected in the SVC at SVC-right atrium junction (CVC(SVC-RA)). RESULTS One hundred and sixty-five cases with mean age of 8.1 ± 4.7 years were reviewed. The CVC(SVC-RA) and CVC carina were significantly correlated with age and body surface area (BSA). Using multiple regression analysis, CVC(SVC-RA) (cm) was equal to 6.4 + 2.8[BSA (m2)] + 0.022[age (month)] and CVC(casina) (cm) equal to 4.9 +2.7[BSA (m2)] +0.013[age (month)] (Adjusted R-squared 0.7275, 0.7140). CONCLUSIONS We recommended the appropriate CVC length via RIJV approach should be between these two calculated lengths and the CVC length in each age according to the BSA.