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Central venous catheters (CVCs) frequently are required in emergency department patients. Optimal catheter placement is close to the border of the superior vena cava (SVC) and right atrium, without crossing into the right atrium. However, determining the junction of the SVC and atrium during catheter placement is challenging. In a prospective, blinded observational study, researchers evaluated the reliability of the CVC tip-to-carina distance as a marker for placement in the atrium.
The researchers randomized 213 elective cardiac surgery patients to CVC insertion by a left or right internal jugular vein approach under electrocardiography guidance, followed by chest radiography. Transesophageal echocardiography (TEE) monitoring was used as th…