Sunday, January 08, 2006

Sunday January 8, 2006
Peres Nomogram or rule of thumb


About 15 years ago, Peres developed a nomogram for probable catheter-insertion depth based on patient height in centimeters and still considered to be applicable/reliable.

For right internal jugular vein central venous catheters, "height (cm)/10" would provide the appropriate depth of insertion. For a 160-cm tall person, a catheter would be inserted to 16 cm deep but for a 200-cm tall person, the depth would be 20 cm.

For left internal jugular, central venous catheter placements, "height (cm)/10 + 4" would provide the appropriate depth of insertion. For a 160-cm tall person, a catheter would be inserted to 20 cm. For a 200-cm tall person, the depth would be 24 cm. (originally described for left external jugular insertion). Caution: In left IJ placement, the catheter tip must not lie at a perpendicular angle against the superior vena cava, because of a risk of vascular erosion.

Reference: Peres PW: Positioning central venous catheters: A prospective survey. Anaesth Intensive Care 1990; 18:536-539