Korean J Crit Care Med.  2006 Jun;21(1):37-41.

The Carina as a Landmark for Evaluation of Adequate Central Catheter Tip Position with Computerized Tomography

• Shin IW
• Park MY
• Choi JY
• Sohn JT
• Lee HK
• Chung YK

Abstract

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.

Keyword

Carina; Central venous anatomy; Central venous catheterization; Complication; Computerized tomography

MeSH Terms

Bays
Body Size
Catheterization, Central Venous
Catheters*
Heart Atria
Humans
Retrospective Studies