Evaluation of formulas for optimal positioning of central venous catheters.

Abstract

OBJECTIVE: To evaluate the accuracy of formulas designed to estimate the optimum intravenous length of central venous catheters. DESIGN: A prospective study of catheter insertion sites to evaluate the accuracy of predetermined formulas that predict the intravascular insertion length required to avoid intracardiac catheter tip placement. SETTING: A 320-bed tertiary hospital. PATIENTS: Critically ill patients requiring central venous access for therapy or monitoring. MAIN RESULTS: The formulas accurately predicted required intravascular length of the central venous catheter in 217 of 228 (95%) cases. The formula for predicting catheter length was most accurate when the subclavian vein was used. It was least accurate when the right internal jugular vein was selected. CONCLUSIONS: The formulas can accurately predict the required length of catheters and thereby reduce the possibility of complications and save time and expense.