• Paediatric anaesthesia · Jan 2005

    Clinical Trial

    Cephalad origin of the superior vena cava and the level of the central venous catheter tip on chest radiographs.

    • Toshimi Arai and Masao Yamashita.
    • Department of Anesthesiology, Ibaraki Children's Hospital, Mito, Ibaraki 311-4145, Japan. tsmarai@nifty.com
    • Paediatr Anaesth. 2005 Jan 1; 15 (1): 47-9.

    BackgroundThere are suggested radiographic landmarks for the lower margin of the superior vena cava (SVC), but none for the cephalad origin of the SVC in children. Therefore, we determined the cephalad origin of the SVC in relation to the level of thoracic vertebrae in children.MethodsSixty-five patients (2-96 months) scheduled for routine diagnostic cardiac catheterization were the subjects of the study. Vena cavogram was obtained. The crossing point between the SVC and the innominate vein was considered as the cephalad origin of the SVC, then this point was related to the level of the thoracic vertebra as a radiographic landmark.ResultsIn approximately 90% of the patients studied the proximal origin of the SVC was situated above the level of Th4/5 interspace.ConclusionWe would like to suggest that the position of the tip of central venous line, when inserted via the right internal jugular vein, should optimally be at the level of Th4/5 interspace on the postoperative chest radiograph.

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