Utility of echocardiography during subclavian vein catheterization and the proper length of right subclavian venous catheter in Korea

Abstract

Study objectives: In inserting the right subclavian venous catheter, there was no report about the proper length of it in Korean patients. It is impossible to check the proper placement of the catheter during insertion, so we depend on chest radiographic findings. We perform this study to decide the proper length and evaluate the utility of echocardiography during right subclavian vein catheterization in Korea. Methods: We conducted a prospective study of 30 patients (male patients 22, mean age 53±18 years) who received a subclavian venous catheter. Exclusion criteria were hemorrhagic tendency, clotting disturbance, vascular injury caused by trauma, and chest wall deformity. In catheterizing, we used the Seldinger method and infraclavicular approach. The radiographic group was defined as patients with chest radiologic confirmation after catheterization. The echocardiographic group was defined as patients with echocardiographic confirmation during catheterization (we visualized the catheter tip by parasternal right venous outflow view and then removed it 2 cm). Results: The length of the right subclavian venous catheter was not different between groups (15.87±2.03 cm versus 15.90±1.74 cm, P =.001). The proper length of the right subclavian catheter did not correlate with the patient's weight ( P =.042) and circumference of chest wall ( P =.371). The proper length of the right subclavian catheter correlated with the patient's height ( P =.001, R 2 =0.394). Conclusion: The proper length of the right subclavian venous catheter in Korea was 15.89±1.86 cm, and the length was correlated with the patient's height. Echocardiography is useful for decision modality of the proper length during insertion of a subclavian vein catheter.