Jump to content


Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org

UVC and an UAC

Recommended Posts

Hello! Happy New Year!

I would be really grateful  if you  could help me with tips for placing an UVC and an UAC.

We in our unit turned out to be placing it - incorrectly.We work with NG  as we don't have

Vygon catheters. How could we determine the position and depth of the catheter?

Thank you  in advance for your help.

Link to comment
Share on other sites

  • 2 weeks later...

What do you mean by placing them incorrectly?

What is interesting is that the original formulas developed in 1960's were developed to have the catheter in the right atrium, what we now know to be unsafe- recent review on methods to calculate insertion length here:


I agree with @Francesco Cardona that POCUS is the way forward here, though we are not currently using it routinely either....

  • Like 1
Link to comment
Share on other sites

We currently have an app that we use but most of us tend to add 1-2cm to this calculation as it often comes out short.  

A manual calculation that often comes out closer to correct insertion length is:  UAC - weight x 3 + 9cm + cord and UVC - 1/2 of UAC length

For determining correct position on xray, T6-9 for UAC and at level of diaphragm but not in right atrium.  We often will do a lateral film (shoot through) along with an AP to determine the UVC tip is above the liver shadow.  

We occasionally will use USS to determine tip of UVC can be seen but is not in right atrium if we want to avoid another xray, however, this is not the most accurate measure.

Link to comment
Share on other sites

We also use: (weight in kg x 3) + 9 + length of cord


This gives us an approximation of UAC depth. Half of UAC length approximates UVC depth. We use an AP radiograph to confirm placement. 


There is a method by which one can use the cardiorespiratory monitor to determine position of the UVC. Essentially you set the monitor to give an auditory beep with each heart beat. Advance the UVC until the frequency of beeps decreases (this implies the tip of the UVC is at the SA node), then pull the UVC back about 1/2 cm and it should be in a pretty good position. However, those I have seen use this technique still confirm with chest radiography. 


I would like to gain experience in POCUS as it might limit exposure to radiation. 

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Create New...