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Defining the surface anatomy of the central venous system in children.
Tarr, Gregory P; Pak, Neda; Taghavi, Kiarash; Iwan, Tom; Dumble, Charlotte; Davies-Payne, David; Mirjalili, S Ali.
Afiliación
  • Tarr GP; Department of Radiology, Auckland City Hospital, Auckland, New Zealand.
  • Pak N; Department of Radiology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Taghavi K; Department of Paediatric Surgery, Wellington Hospital, Wellington, New Zealand.
  • Iwan T; Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
  • Dumble C; Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
  • Davies-Payne D; Department of Radiology, Auckland City Hospital, Auckland, New Zealand.
  • Mirjalili SA; Department of Anatomy with Radiology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Clin Anat ; 29(2): 157-64, 2016 Mar.
Article en En | MEDLINE | ID: mdl-26518452
Pediatric emergency physicians, pediatric critical care specialists, and pediatric surgeons perform central venous catheterization in many clinical settings. Complications of the procedure are not uncommon and can be fatal. Despite the frequency of application, the evidence-base describing the surface landmarks involved is missing. The aim of the current study was to critically investigate the surface markings of the central venous system in children. The superior vena cava/right atrial (SVC/RA) junction, superior vena cava (SVC) formation, and brachiocephalic vein (BCV) formation were examined independently by two investigators. Three hundred computed tomography (CT) scans collected across multiple centers were categorized by age group into: 0-3 years, 4-7 years, and 8-11 years. Scans with pathology that distorted or obscured the regional anatomy were excluded. The BCV formation was commonly found behind the ipsilateral medial clavicular head throughout childhood. This contrasts with the variable levels of SVC formation, SVC length, and SVC/RA junction. In the youngest group, SVC formation was most commonly at the second costal cartilage (CC), but moved to the first CC/first intercostal space (ICS) as the child grew. The SVC/RA junction was at the fourth CC in the youngest group and moved to the third CC/third ICS as the child grew. This study demonstrates the variable anatomy of SVC formation and the SVC/RA junction with respect to rib level. This variability underscores the unreliability of surface anatomical landmarks of the SVC/RA junction as a guide to catheter tip position.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vena Cava Superior / Venas Braquiocefálicas / Puntos Anatómicos de Referencia Límite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Clin Anat Asunto de la revista: ANATOMIA Año: 2016 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vena Cava Superior / Venas Braquiocefálicas / Puntos Anatómicos de Referencia Límite: Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: Clin Anat Asunto de la revista: ANATOMIA Año: 2016 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Estados Unidos