Crtical Care and Shock Journal

Prediction of optimal right internal jugular vein catheter depth: comparison between Peres’ formula and intracavitary ECG

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Overview

Abstract

Background: Incorrect central venous catheter (CVC) placement can lead to serious complications. In order to prevent complications, CVC insertion depth can be predicted using Peres’ formula or intracavitary electrocardiography (ECG). The accurate prediction of optimal CVC depth using Peres’ formula and intracavitary ECG on Malay race is unknown.

Objective: To compare the accuracy of Peres’ formula and intracavitary ECG in predicting the optimal depth of right internal jugular venous catheter on adult Malay race.

Methods: This was a comparative analytic observational study with cross sectional design conducted at Cipto Mangunkusumo National General Hospital Jakarta from May to July 2017. After obtaining approval from the local ethical committee, right internal jugular venous catheter insertion was attempted on 111 patients, but 7 subjects were excluded from the study. Statistical analysis was performed on 104 samples to determine the accuracy of CVC depth prediction based on Peres’ formula and intracavitary ECG using McNemar’s test. The CVC depth prediction formula in adult Malay subject was calculated using linear regression based on its correlation with age, height, and body weight.

Results: The accuracy of intracavitary ECG and Peres’ formula to predict the optimal depth of right internal jugular venous catheter was 75% and 11.5%, respectively. The difference between the accuracy of these two methods was statistically significant (p=0.001). Correlation analysis showed a significant relationship between height and the optimal depth of right internal jugular vein catheter. The CVC depth prediction formula obtained in this study was 4.143 + (0.058 x height in cm).

Conclusion: Prediction of right internal jugular venous catheter depth using intracavitary ECG is more accurate than the Peres’ formula.

Aida Rosita Tantri, Aldy Heriwardito, Hana Nur Ramila

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