A New Formula to Estimate the Length of Right Upper Extremity Vein from Elbow Crease to Carina Calculated by Peripherally Inserted Central Catheter Insertion through Right Basilic Vein Puncture

Abstract

Since the first attempt to use upper extremity veins to access to the central venous system in 1912, peripherally inserted central catheter (PICC) has become more popular primarily for the infusion of antineoplastic agents, fluid replacement, long-term parenteral nutrition, as well as monitoring central venous pressure (1-3). Although PICCs play an essential role in the care of critically ill patients, they are associated with serious complications such as arrhythmia, thrombosis, phlebitis, and cardiac perforations. For proper monitoring of central venous pressure and a decrease of the risk of complications, it is mandatory to achieve appropriate catheter tip position (4-6). Currently, PICCs are frequently inserted at the patient’s bedside blindly (without fluoroscopic guidance), followed by chest radiographic confirmation of correct catheter tip position. In that situation, it would be useful for the adequate catheter tip placement to estimate the length of the upper extremity vein prior to the PICC procedure by considering a patient’s characteristics such as height. To our knowledge, however, there has been no published article concerning the direct measurement of upper extremity vein length for appropriate positioning of the PICCs. Original Article