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Korean J Crit Care Med > Volume 21(1); 2006 > Article
Korean Journal of Critical Care Medicine 2006;21(1): 37-41.
전산화 단층촬영에 의한 중심정맥도관 위치평가에 기관용골의 해부학적 의의
경상대학교 의과대학 *마취통증의학교실 및 †건강과학연구원
The Carina as a Landmark for Evaluation of Adequate Central Catheter Tip Position with Computerized Tomography
Il Woo Shin, Mi Young Park, Ju Young Choi, Ju Tae Sohn, Heon Keun Lee, Young Kyun Chung
1Department of Anesthesiology and Pain Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea. ykchung@nongae.gsnu.ac.kr
2Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea.
BACKGROUND: The aim of this study was to determine whether the carina can be used as a landmark for evaluation of adequate central catheter tip position, and to examine the relationship between easily measurable body size and variable anatomical parameter. METHODS: The SVC dimensions and relationship to radiographic landmarks were retrospectively determined from computerized tomography (CT) scans of 200 patients. The CT findings were assessed in terms of SVC length (SVCL), the distance between the carina and the right atrium inlet (CAL), and the sternal length (STL). Pearson's correlation and a regression test for height versus SVCL, STL versus SVCL and CAL were performed. RESULTS: The median length of the SVC was 4.2 cm (range; 1.6 to 7.2 cm) and the distance between the carina and the right atrium inlet was 2.4 cm (range; 0.8 to 5.6 cm). With the regression test, height was correlated with SVCL (r(2)=0.09), and STL was correlated with both SVCL (r(2)=0.12) and STL (r(2)=0.04). CONCLUSIONS: The carina was located always above the right atrium inlet. The carina was a reliable, simple anatomical landmark for the determination of correct placement with computerized tomography.
Key Words: Carina; Central venous anatomy; Central venous catheterization; Complication; Computerized tomography
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