Predicting the optimal depth of ultrasound-guided right internal jugular vein central venous catheters in neonates.

Autor: Montes-Tapia F; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Pediatric Surgery, Department of Pediatrics, Monterrey, Mexico. Electronic address: fernando.montestp@uanl.edu.mx., Hernández-Trejo K; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Department of Pediatrics, Monterrey, Mexico., García-Rodríguez F; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Department of Pediatrics, Monterrey, Mexico., Jaime-Reyes J; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Department of Pediatrics, Monterrey, Mexico., Treviño-Garza C; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Department of Pediatrics, Monterrey, Mexico., Cárdenas-Del Castillo B; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Neonatology, Department of Pediatrics, Monterrey, Mexico., Rodríguez-Balderrama I; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Neonatology, Department of Pediatrics, Monterrey, Mexico., de la O-Cavazos M; Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario, 'Dr. Jose Eleuterio Gonzalez', Department of Pediatrics, Monterrey, Mexico.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2020 Sep; Vol. 55 (9), pp. 1920-1924. Date of Electronic Publication: 2019 Dec 30.
DOI: 10.1016/j.jpedsurg.2019.12.004
Abstrakt: Background: Poor positioning of a central venous catheter (CVC) can cause severe complications. The objective is to create a formula that predicts the optimal insertion depth of a real time ultrasound-guided CVC in the right internal jugular vein (RIJV) in newborns.
Methods: Between 2015 and 2017, 91 newborns that required a CVC were included in a prospective observational study. Variables such as gestational age, gender, weight, height, and neck length were studied. On the chest x-ray, the distance between the insertion site on the skin and the catheter tip was measured.
Results: Of the patients included, 50 (54.9%) were males and 40 (44.4%) females; 64 (70.3%) were preterm. Mean gestational age was 33.44 (25 to 41) weeks, weight 2020 (580 to 3980) g, and height 43.04 (26 to 53) cm. Variables were correlated with catheter length and an algorithm was modeled for the introduction method, in which the highest corrected determination coefficient was obtained for weight (R 2  = 0.723).
Conclusion: This study demonstrated that the weight of the newborn was the most significant individual predictor of optimal insertion depth of a CVC in the RIJV. The formula Y = 2.6 + 0.7 (weight in kg) that we suggest is practical and reproducible.
Level of Evidence: Level IV.
Competing Interests: Conflicts of interest The author declare that they have no conflicts of interest.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE