• Manuel F Struck, Thomas Schmidt, Bernd E Winkler, Konrad Reinhart, and Wolfram Schummer.
• Department of Anaesthesiology and Intensive Care Medicine, University Hospital Leipzig, Leipzig - Germany.
• J Vasc Access. 2016 Mar 1; 17 (2): 191-4.

PurposeWhether formulas for prediction of central venous catheter (CVC) insertion depths have different applicability in patients with different body heights is not known. Goal of study was to test formulas for catheterizations of internal jugular veins (IJVs) in a population of different body height classes with correct CVC tip positions.MethodsConsecutive adult patients requiring CVC for cardiac surgery were enrolled and those with tip positions at the junction of the superior vena cava and the right atrium ±1 cm underwent formula analysis. Precision of formula prediction was calculated for three classes of body height.ResultsOf the 635 included patients, 254 underwent right IJV catheterization and 381 underwent left IJV catheterization, respectively. Formula-guided approach for both right [formulas (height/10) (in cm) and (height/10) -1 (in cm)] and left [formula (height/10) + 4 (in cm)] IJV CVC was more precise in patients with a body height of 170-180 cm compared with patients with a body height <170 cm (who required deeper insertion than predicted by formula) and patients with a body height >180 cm (who required a more proximal insertion than predicted by formula).ConclusionsIndependent from body height classes, all formulas calculated a relatively low likelihood of atrial positions but high risks of proximal mal-positioning. Thus, considering inter-individual differences of vascular anatomy and for safety reasons, formulas cannot be recommended.

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