Optimal Central Venous Catheter Placement

 Confirm that the catheter is placed correctly in the vein and that the tip is in the desired position using a chest radiograph. Ideally, the tip of the catheter should be roughly parallel with the wall of the superior vena cava, caudal to the inferior margin of the clavicle, between the third rib and the fourth/fifth thoracic vertebra, and cranial to the bifurcation of the trachea or right primary bronchus (see Fig ).

The bifurcation of the trachea is usually positioned cranial to the pericardial reflection; thus, it is best if the tip of the catheter is always cranial to this. If perforation due to erosion of the vessel wall occurs, a mediastinal hematoma may occur, transfusion fluid may enter the chest cavity cranial to the pericardial reflection, or cardiac tamponade may occur caudal to this area.


catheter placement


Optimal catheter placement. Zone A, inferior portion of the superior vena cava up to the superior portion of the right atrium; zone B, portion of the right innominate vein confluent with the left innominate vein and the superior portion of the superior vena cava; zone C, innominate vein peripheral to the superior vena cava.

Source: Safety Committee of Japanese Society of Anesthesiologists


Popular posts from this blog

Ketamine: The Past, Present, and Potential Future of an Anesthetic Drug

Ketamine is a powerful anesthetic drug that has been used in medical settings for decades. However, its effects on the brain have also led to its use as a recreational drug, leading to controversy surrounding its use. Despite its negative associations, recent research has shown promising potential for the drug in the treatment of mental health conditions such as depression and post-traumatic stress disorder (PTSD).
Read more

Fast track anesthesia approaches

  Fast track anesthesia schemes are multi-modal approaches that aim to reduce the physiological stress response to surgery, enhance recovery, and improve patient outcomes. These schemes typically involve several aspects of perioperative care, including anesthesia management, surgical technique, pain management, fluid management, and early mobilization. Here are some common fast track anesthesia schemes:
Read more