Abstract
Backgroundː The carina is considered a reliable marker for the depth of right internal jugular vein catheterisation in infants. However, the carina is not always visible on chest radiographs, whereas vertebral bodies usually are. We performed a retrospective analysis of routine post-procedural chest radiographs of infants who had undergone congenital heart surgery and required central venous catheterisation. We evaluated the possibility of using vertebral bodies as radiographic landmarks for the identification of the depth of right internal jugular vein catheterisation.Methodsː In total, 108 infants (aged 1–12 months) who underwent congenital heart surgery from the 1st of January, 2019, to the 30th of June, 2019, were included. We analysed the post-operative chest radiographs of those who underwent right internal jugular vein catheterisation and assessed the visibility of the carina and vertebral bodies, as well as their positional relationship.Resultsː In total, 95 children were enrolled; in 61 (64%) cases, the carina was visible on the chest radiograph, whereas in 34 (36%) cases, it was not visible. In all 95 (100%) cases, the vertebral bodies were clearly visible. There was a significant difference between the rate of visibility of the carina and vertebral bodies (P=0.01 P<0.05). The carina was located at the third thoracic vertebra in one case (2%) and at the fourth thoracic vertebra in 60 cases (98%). There was a significant difference in the position of the carina (P=0.01, P<0.05).Conclusionsː Most fourth thoracic vertebrae were at the same level as the carina on chest radiographs. The fourth thoracic vertebra, therefore, has potential as a radiographic landmark for the depth of right internal jugular vein catheterisation in infants when the position of the carina is not visible on the chest radiograph.
Landmark guided internal jugular vein catheterization in infants undergoing congenital heart surgery
