Evaluation of the catheter tip position among children with totally implantable port during 2015 in Dr. Sheikh Children’s hospital

Reza Shojaeian, mohammad mahdi khazravi

Abstract


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Background: Totally implantable port insertion is a common procedure in pediatrics surgery and the main concern is the tip catheter position, which is directly related to its complications, failure and durability. The best position is in SVC/RA junction which is compatible with carina or T5-T6 vertebral level in X-ray.

In our center we routinely use surface anatomy to estimate the adequate length for the tip to reach SVC/RA junction. In this study we compared the precision and accuracy of this method by post-operative X-ray study.

Materials and methods: as a retrospective study we evaluated the accuracy of surface anatomical land marks to estimate the catheter tip position, considering the carina or vertebra in X-rays which represents the SVC/RA junction. 48 patients were included and their records were reviewed in Dr. Sheikh Children’s hospital (Mashhad).

Results: Considering the carina as the best radiographic land mark, we had accurate tip position just  in 29.2%,over insertion in 45.8% and under inserted catheter tip in 10.4%.Considering the vertebral bodies as radiographic land mark,50% were over inserted ,35.4% accurate and 14.6% under inserted.

Conclusion: Regarding our high rate of catheter tip mal-position arising from considering surface anatomy alone, we suggest not only to rely on surface anatomy but use imaging modalities such as portable X-ray, fluoroscopy or ultra-Sonography within the operation room while inserting implantable port devices.


Keywords


Keywords: pediatrics; implantable catheter; superior vena cava; access port; chest x ray

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References


-Witthayapraphakorn L, Khositseth A, Jiraviwatana T, Siripornpitak S, Pornkul R, Anantasit N, Vaewpanich J. Appropriate length and position of the central venous catheter insertion via right internal jugular vein in children. Indian Pediatr. 2013 Aug;50(8):749-52.

- Tarr GP, Pak N, Taghavi K, Iwan T, Dumble C, Davies-Payne D, Mirjalili SA. Defining the surface anatomy of the central venous system in children. Clin Anat. 2016 Mar;29(2):157-64.

- Yoon SZ, Shin TJ, Kim HS, Lee J, Kim CS, Kim SD, Park CD. Depth of a central venous catheter tip: length of insertion guideline for pediatric patients. Acta Anaesthesiol Scand. 2006 Mar;50(3):355-7.

- Yoon SZ, Shin JH, Hahn S, Oh AY, Kim HS, Kim SD, Kim CS. Usefulness of the carina as a radiographic landmark for central venous catheter placement in paediatric patients. Br J Anaesth. 2005 Oct;95(4):514-7.

- Dulce M, Steffen IG, Preuss A, Renz DM, Hamm B, Elgeti T. Topographic analysis and evaluation of anatomical landmarks for placement of central venous catheters based on conventional chest X-ray and computed tomography. Br J Anaesth. 2014 Feb;112(2):265-71.

- Kim SC, Heinze I, Schmiedel A, Baumgarten G, Knuefermann P, Hoeft A, Weber S. Ultrasound confirmation of central venous catheter position via a right supraclavicular fossa view using a microconvex probe: an observational pilot study. Eur J Anaesthesiol. 2015 Jan;32(1):29-36.

- Nowlen TT, Rosenthal GL, Johnson GL, Tom DJ, Vargo TA. Pericardial effusion and tamponade in infants with central catheters. Pediatrics. 2002 Jul;110(1 Pt

:137-42.

- Yoder D. Cardiac perforation and tamponade: the deadly duo of central venous catheters. Int J Trauma Nurs. 2001 Jul-Sep;7(3):108-12.

- Na HS, Kim JT, Kim HS, Bahk JH, Kim CS, Kim SD. Practical anatomic landmarks for determining the insertion depth of central venous catheter in paediatric patients. Br J Anaesth. 2009 Jun;102(6):820-3




DOI: https://doi.org/10.22037/irjps.v4i2.21466

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