Identifying the Suitable Depth for Central Venous Catheter placement: The Conventional 15 centimeter or CLength approach

Central vein catheterization is a standard clinical method for central venous pressure monitoring besides being used for other therapeutic purposes. The present guidelines recommend to place the catheter tip in the superior vena cava above the pericardial cephalic reflection. The aim of this study was to compare the accuracy of two different approaches in locating the tip of the CVC at the suggested vascular zone.
Material and This was an interventional study on 100 patients undergoing CABG operation who required a central venous cannulation. They were randomly assigned into two groups. In the first group catheter placement was applied through using the conventional 15 cm method. In the second group a Clength method was applied for measuring the depth of catheter tip insertion from the preoperative chest radiographs. For statistical analysis Chi-square test and T-test were used (SPSS v.22 software).
In the first group (15 cm)100% of the patients had their catheters placed below the C-line (Carina line) and the average distance between the catheter tip and the C-line was 4.22±2.10 cm. In the second (CLength) group 52% of the catheters were below C-line with an average distance of 0.77±0.5 cm. There was a meaningful difference between the two groups in respect to the catheter location depth and zone placement. (P=0.00).
The C-Length approach in comparison to the conventional 15 cm approach resulted in a considerable higher number of catheters above the recommended C-line, thus it can provide a more reliable and safe mode for CVC placement in the SVC.