Comparison of the Depth of Central Venous Catheterization Tip In The Left Subclavian Using The Peres Formula With Radiological Evaluation Of Supraclavicular And Infraclavicular

Abstract

Introduction : Central Venous Pressure (CVP) is the measure most often used to guide fluid resuscitation in critically ill patients. CVC placement has become common practice for anesthesiologists and intensivists in operating theaters and intensive care units. It is very important to position the catheter tip in the correct position to avoid the consequences of malposition. Objective : To determine the comparison of the accuracy of the tip depth of central venous catheterization in the left subclavian using the Peres formula with evaluation of the radiological images between the supraclavicular and infraclavicular. Methods : This study used a double blind RCT ( Randomized Clinical Trial ) design , ie the research subjects and observers did not know the treatment or intervention given. Sample study are patients who have a central venous catheter installed in the emergency room, ICU, or surgery at the Adam Malik Haji Center General Hospital in Medan who fulfill criteria inclusion and exclusion. Results : The frequency of Supraclavicular samples with incorrect tips was 36 samples (42.4%) and 9 samples (10.6%) were correct. Furthermore, for the experiment using the inflaclavicular as many as 32 samples (37.6%) were not correct, while 8 samples (9.4%) the tip was correct. It is known that the analysis was carried out using the Chi-Square test and it was known that there was no significant relationship between groups with the level of accuracy of central venous catheter tip depth (p = 1.000). Conclusion : The accuracy of central venous catheterization in the left subclavian using the Peres formula supraclavicular and infraclavicular is known to be the same, namely 20.0% or 1 out of 5 procedures directly reaches the carina/region about the fifth thoracic vertebra which does not have a significant difference between infraclavicular and supraclavicular.