Ching-Yang Wu1, Jui-Ying Fu2, Ching-Feng Wu3, Ming-Ju Hsieh3, Chi-Tsung Wen3, Chia-Hui Cheng4, Yun-Hen Liu3, Po-Jen Ko3. 1. Thoracic and Cardiovascular Surgery Division, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address: wu.chingyang@gmail.com. 2. Chest Division, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. 3. Thoracic and Cardiovascular Surgery Division, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. 4. Cardiovascular Physiology Laboratory, Department of Medical Research and Development, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Abstract
BACKGROUND: Adequate tip location is crucial for intravenous port implantation because it can minimize catheter-related complications. Adequate tip location cannot be observed directly and needs to be confirmed by imaging tools. A quantified intravascular catheter length formula has been proposed and we attempt to compare its clinical effectiveness with anatomic landmark references. METHODS: During the period from March 2012 to February 2013, 503 patients who received port implantation where implanted catheter length depended on carina level as confirmed by intraoperative fluoroscopy were assigned to Group A. From March 2013 to February 2014, 521 patients who received port implantation based on quantified intravascular catheter length formula were assigned to Group B. Clinical outcomes were compared. RESULTS: Catheter tip location of Group A, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.18 ± 0.51 and 1.1 ± 1.3 cm below carina, respectively. Catheter tip location of Group B, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.25 ± 1.05 and 1.05 ± 1.32 cm below carina, respectively. Similar catheter tip location was identified in both groups. The functional period of implanted ports, complication rate (3.58% and 2.53%), and incidence (0.049 and 0.0506 episodes/1,000 catheter days) were similar in both groups. CONCLUSIONS: The quantified intravascular catheter length formula can predict an adequate catheter length just as well as carina do and results in good catheter tip location. The formula could replace the clinical use of anatomic landmarks and serve as an easy tool for practitioners.
BACKGROUND: Adequate tip location is crucial for intravenous port implantation because it can minimize catheter-related complications. Adequate tip location cannot be observed directly and needs to be confirmed by imaging tools. A quantified intravascular catheter length formula has been proposed and we attempt to compare its clinical effectiveness with anatomic landmark references. METHODS: During the period from March 2012 to February 2013, 503 patients who received port implantation where implanted catheter length depended on carina level as confirmed by intraoperative fluoroscopy were assigned to Group A. From March 2013 to February 2014, 521 patients who received port implantation based on quantified intravascular catheter length formula were assigned to Group B. Clinical outcomes were compared. RESULTS: Catheter tip location of Group A, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.18 ± 0.51 and 1.1 ± 1.3 cm below carina, respectively. Catheter tip location of Group B, as revealed by intraoperative fluoroscopy and postoperative chest film, was 1.25 ± 1.05 and 1.05 ± 1.32 cm below carina, respectively. Similar catheter tip location was identified in both groups. The functional period of implanted ports, complication rate (3.58% and 2.53%), and incidence (0.049 and 0.0506 episodes/1,000 catheter days) were similar in both groups. CONCLUSIONS: The quantified intravascular catheter length formula can predict an adequate catheter length just as well as carina do and results in good catheter tip location. The formula could replace the clinical use of anatomic landmarks and serve as an easy tool for practitioners.