Background: Cardiac tamponade is rare but one of the most serious complications in relation to central venous catheters (CVC). The tip of the CVC should be placed outside the pericardium to avoid tamponade. In adults, the carina is always located above the pericardium; therefore, the carina is a reliable landmark for CVC placement. We examined whether the carina could also be an adequate landmark for CVC placement in neonates.
Methods: The study was conducted using nine fresh neonatal cadavers. The longitudinal distance between the carina and the pericardium as it transverses the superior vena cava (the pericardial reflection: PR) was measured.
Results: The median postconceptional age (gestational age in weeks + weeks after delivery) at autopsy was 35 (range: 23-42) weeks. The PR was located at a distance of 4 mm above to 5 mm below the carina. Unlike in adults, the position of the PR varies in relation to the carina in neonates. In seven of the nine subjects, the location of the PR was above the carina.
Conclusions: In neonates, the carina is not always located above the pericardium, as it is in adults; therefore, the carina is not an appropriate landmark for CVC placement.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1460-9592.2007.02258.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk factors for a failed first attempt at pediatric subclavian central venous catheters and the role of single-attempt placement in reducing catheter-related morbidity: a prospective observational study.
Br J Nurs
November 2024
Pediatric Surgery Department, Hedi Chaker University Hospital: University of Sfax, Tunisia.
Introduction: The aim of this observational study was to investigate the risk factors of a failed first attempt at pediatric central venous catheter (CVC) placement and its impact on CVC-related morbidity.
Materials And Methods: In this prospective observational study, we included 3-month-to 5-year-old children proposed for infraclavicular subclavian vein catheterization consecutively sing the anatomic landmark technique. Patients were divided into two groups: group 1 included single-attempt catheter placements, and Group 2 included failed first attempts at catheter placement.
Central venous catheter-related infections: a systematic review, meta-analysis, trial sequential analysis and meta-regression comparing ultrasound guidance and landmark technique for insertion.
Crit Care
November 2024
UR-UM103 IMAGINE, Univ Montpellier, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Montpellier, France.
Background: During central venous catheterization (CVC), ultrasound (US) guidance has been shown to reduce mechanical complications and increase success rates compared to the anatomical landmark (AL) technique. However, the impact of US guidance on catheter-related infections remains controversial. This systematic review and meta-analysis aimed to compare the risk of catheter-related infection with US-guided CVC versus AL technique.
View Article and Find Full Text PDFValue of projectional imaging relative to cross-sectional imaging to assess catheter tip position in the superior vena cava: evaluation of reader variability.
Br J Radiol
February 2025
Department of Diagnostic and Interventional Radiology, University Hospital, 1011 Lausanne, Switzerland.
Objectives: The cavo-atrial junction (CAJ) is the most appropriate central venous catheters CVC tip location to reduce complications. Among chest X-ray (CXR) landmarks for tips assessment, only the pericardial reflection lies in the same plane as the vascular structures. We aimed to evaluate the observer variability to determine tip positioning on CXR, using CT as a gold standard.
View Article and Find Full Text PDFAugmented reality visualization for ultrasound-guided interventions: a pilot randomized crossover trial to assess trainee performance and cognitive load.
BMC Med Educ
September 2024
School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Taiwan, No.1, University Road, Tainan City 701, Tainan, Taiwan.
Background: Augmented reality (AR) technology involving head-mounted displays (HMD) represents a significant innovation in medical education, particularly for training in guided invasive procedures. Novice physicians often face challenges in simultaneously identifying anatomical landmarks and performing procedures when learning point-of-care ultrasound (POCUS). Our primary objective was to determine the effectiveness of AR in enhancing physician training for ultrasound-guided interventions using AR visual overlays.
View Article and Find Full Text PDFOptimising central venous catheter placement by comparing cavoatrial junction position to chest X-ray landmarks: A cross-sectional study using CT chest reconstruction.
J Med Imaging Radiat Oncol
September 2024
Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
Article Synopsis
- This study investigates the accuracy of central venous catheter (CVC) tip placement using chest X-ray (CXR) landmarks, aiming to reduce inconsistencies in positioning.
- Researchers analyzed chest CT scans of 100 patients to establish the relationship between the cavoatrial junction (CAJ) and specific CXR landmarks, measuring the vertical distances for comparison across different demographics.
- The findings revealed a new landmark, the mid-superior right heart border, which is the closest to the CAJ and suggests that CVC tips can be placed at this position for improved accuracy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!