Evaluation of Surface Landmarks and C-length as Predictors of the Depth of Right Internal Jugular Venous Catheter Insertion: A Transesophageal Echocardiography-Guided Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Accuracy of surface landmarks for prediction of CVC depth required to place the CVC tip at the mid-SVC.
研究概览
简要总结
The primary aim of this study is to derive a prediction rule to estimate the required length for placement of the CVC tip at the mid-point of the SVC from simple anatomical landmarks that are consistent with the known surface projections of the great veins. The accuracy of this rule will be examined using TEE and is intended for adult patients undergoing cannulation of the right IJV utilizing a middle approach. As a secondary aim, we will examine the performance of this suggested rule as contrasted with two other popular methods for estimation of the CVC length, the Peres formula and the C-length method.
详细描述
Before induction of anesthesia
Three sets of measurements will be obtained for each participant before induction of anesthesia:
- Surface measurements: Three points will be placed on the skin using a non-erasable marker. Point A, at the apex of the triangle between the two heads of the sternomastoid. Point B, at the ipsilateral sternoclavicular joint. Point C, at the lower border of the right 2nd rib at its junction with the sternum. The distance between point A and point B and between point B and point C will be measured and added to each other to determine the catheter length expected to place the tip at the mid-SVC.
- Radiological measurements: On the plain posteroanterior (PA) chest X-ray (CXR), the distance from the tip of the transverse process of T1 to the tracheal bifurcation (C-length) will be measured.
- Using Peres' formuls (Height in cm/10), we will record the anti After induction of anesthesia After induction of anaesthesia, the TEE probe will be placed and a bicaval view will be displayed to visualize the right atrium-superior vena cava (RA-SVC) junction and the proximal (lower) part of the SVC at its entry into the right atrium (RA). The TEE probe will be manipulated to display the SVC as far as possible from its junction with the RA.
The right internal jugular vein (IJV) will be cannulated under ultrasound guidance using the Seldinger technique.
After puncture of the IJV a J-wire will be advanced through the trocar until the J-end of the guidewire is visualized at the RA-IJV junction via the TEE.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult subjects (age 18 years or older).
- •Elective cardiac surgery.
- •Echocardiography is indicated or recommended.
排除标准
- •Previous cardiothoracic or neck surgery.
- •Previous radiotherapy on the neck or chest.
- •Intra-thoracic or neck mass lesions.
- •Deformity of the chest wall.
- •Anomalies of the great vessels.
- •Congenital heart disease.
结局指标
主要结局
Accuracy of surface landmarks for prediction of CVC depth required to place the CVC tip at the mid-SVC.
时间窗: Outcome will be assessed at completion of catheterization procedure
Difference between actual length required to place the CVC tip at the mid-SVC as guided by TEE and the distance from the entry point to the surface point corresponding to the mid-SVC on the chest wall.
Accuracy of C-length for prediction of CVC depth required to place the CVC tip at the mid-SVC.
时间窗: Outcome will be assessed at completion of catheterization procedure
Difference between actual length required to place the CVC tip at the mid-SVC as guided by TEE and the C-length.
次要结局
未报告次要终点
研究者
Sameh M. Hakim
Professor of Anesthesiology, Intensive Care and Pain Management
Ain Shams University