Cho et al reported a formula for predicting the length of a PICC line in a patient. The authors are from University of Ulsan, Korea University, Soonchuhyang University and affiliated hospitals in South Korea.
Parameters:
(1) maximal horizontal thoracic diameter in cm (MHTD, horizontal line between the medial aspect of the ribs near the costophrenic angle)
(2) clavicle length in cm
(3) distance of thoracic vertebrae in cm (vertical distance from the top of T1 to the bottom of T12)
(4) vertebral body unit (VBU) in cm (vertical height of body)
(5) distance from the cubital crease to the puncture point in cm (CP)
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Parameter
|
Finding
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MHTD
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0.424 * (MHTD)
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clavicle length
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0.287 * (length)
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distance of thoracic vertebrae
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0.203 * (distance)
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vertebral body unit
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2 * (VBU)
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distance from the cubital crease to the puncture point plus estimated PICC length =
= SUM(points for all of the parameters) + 19.409
estimated PICC length in cm =
= SUM(points for all of the parameters) + 19.409 - (distance from the cubital crease to the puncture point)
Adjustments:
(1) add 3.063 cm if entering from the left arm
(2) subtract 0.997 if female gender
Optimal zone: from inferior carina to position 2 VBU inferior. The cavoatrial junction is in the midpoint of this range.
Performance:
• The positioning was optimal in 71% of cases.
