The accuracy of peres' formula and topography anatomy in predicting the depth of CVC for installation in the right subclavia

Abstract

Central venous catheter (CVC) insertion is a routine procedure in either intensive care or in perioperative circumstances. A simple and accurate method or rule is needed to predict the optimum depth of the CVC. The aim of this study is to evaluate the position and depth of CVCs using Peres' formula ([height/10]-2) and landmark measurements, as well as assessing the incidence of malpositions of CVC installation. This research was an analytic observational study. Fifty patients undergoing central venous catheter (CVC) installation with the right subclavian vein approach were divided into two groups: a Peres' formula ([height/10]-2) and an anatomy topography measurement group. The results of the calculations were used to determine the boundary prediction of skin fixation. CVC depth was evaluated by measuring the distance between the distal end of the CVC and the carina, from chest radiographs. The measurement results were analyzed by a Bland and Altman plot. The patient's characteristics were equal for both groups. In the Peres' formula group we found that the mean of the distal CVC was 1.5 (0.82) cm under the carina (CI 95%: 1.2 to 1.9 cm), with the limit of agreement as 0.0 cm to 3.0 cm. The mean of the landmark group was 0.85 (0.73) cm (CI 95%: 0.5 to 1.1 cm) with the limit of agreement as -0.5 cm to 2.2 cm. The incidence of malposition was found to be similar in both groups. The results showed that both prediction methods are not accurate enough to predict the depth of CVC insertion in Indonesian people.