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Intra- and extra-pericardial lengths of the superior vena cava in vivo: Implication for the positioning of central venous catheters

 T. D. KWON  ;  K. H. KIM  ;  J. H. BAHK  ;  J. M. GOO  ;  C. W. JUNG  ;  H. G. RYU 
 Anaesthesia and Intensive Care, Vol.33(3) : 384-387, 2005 
Journal Title
 Anaesthesia and Intensive Care 
Issue Date
Adolescent ; Adult ; Aged ; Cardiac Tamponade/etiology* ; Cardiac Tamponade/prevention & control ; Catheterization, Central Venous/adverse effects* ; Coronary Artery Bypass ; Female ; Heart Valve Prosthesis ; Humans ; Intraoperative Complications/etiology ; Intraoperative Complications/prevention & control ; Male ; Middle Aged ; Vena Cava, Superior/anatomy & histology*
To reduce the possibility of cardiac tamponade, a rare but lethal complication of central venous catheters, the tip of the central venous catheter should be located above the cephalic limit of the pericardial reflection, not only above the superior vena cava-right atrium junction. This study was performed to measure the superior vena cava lengths above and below the pericardial reflection in cardiac surgical patients. Cardiac surgical patients (n = 61; 27 male), whose age [mean +/- SD (range)] was 47 +/- 15 (15-75) years, were studied. The intrapericardial and extrapericardial lengths, and the length of the medial duplicated part were measured separately. The whole vertical lengths of the superior vena cava on either side were calculated respectively by adding the intra-and extrapericardial and medial duplication lengths. The lateral extrapericardial was 29.1 +/- 6.5 (Mean +/- SD) (9-49) mm (range), and lateral extrapericardial length was 32.6 +/- 6.9 (20-53) mm. The medial extrapericardial length was 23.3 +/- 5.0 (11-39) mm, medical duplicated length was 7.2 +/- 3.3 (4-20) mm, and medial intrapericardial was 28.3 +/- 7.0 (20-52) mm. The averaged superior vena cava length of both sides was 60.3 +/- 9.0 (44.5-90) mm. Almost half of the superior vena cava was found to be within the pericardium and half out. This information may be helpful in deciding how far a central venous catheter should be withdrawn beyond the superior vena cava-right atrial junction during right atrial electrocardiographic guided insertion, and in the prediction of optimal central venous catheter insertion depth.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kweon, Tae Dong(권태동) ORCID logo https://orcid.org/0000-0002-5451-1856
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