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중심정맥도관 삽입 시 도관의 우심방 내 위치 확인을 위한 단순흉부촬영 영상 지표로서 기관용골-중심정맥도관 끝 거리의 유용성

Other Titles
 Usefulness of Tip-to-Carina Distance as a Marker for Detecting Right Atrium Positioning of a Central Venous Catheter on Chest X-Ray 
Authors
 박준민  ;  정태녕  ;  김민정  ;  김선욱  ;  박유석  ;  정성필  ;  김승호 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.20(6) : 635-641, 2009 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2009
Keywords
Catheterization ; Central venous ; Radiography ; Thoracic ; Methods
Abstract
Purpose: Our goal was to check the effect of physique on tip-to-carina (TC) distance for detecting the right atrium (RA) position of a central venous catheter tip, and to determine the optimal cut-off value for TC distance. Methods: We did a retrospective review of patients who were given chest computed tomography within 12 hours after central venous catheterization (CVC) between September 2005 and February 2009. We used electronic medical records (EMR) and a picture archiving communication system (PACS). TC/height ratio and TC/thoracic width ratio were used as height and thoracic width corrected TC distances. We developed receiver operating characteristic (ROC) curves for TC distance, TC/height and TC/thoracic width, and compared the area under curves (AUCs) of each. An optimal cut-off value for TC distance was obtained using ROC curves. Results: A total of 88 patients were enrolled in our study to determine the optimal cut-off value for TC distance. Of the 88, records for 64 included height, which was required for comparing TC with height and thoracic width corrected TC. AUCs of TC, TC/height, and TC/thoracic width were, respectively, 0.966, 0.962, 0.970. There was no statistically significant differences between them. The cut-off value for TC distance for detecting RA positioning of a CVC is 30 mm (Sensitivity=100%, Specificity=85.1%). Conclusion: TC distance is a useful marker for detecting RA positioning of a CVC regardless of the patient`s height and thoracic width. We suggest 30 mm as the optimal cutoff value for TC distance.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Sun Wook(김선욱)
Kim, Seung Ho(김승호)
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Tae Nyoung(정태녕)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/105924
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