Central vein catheterization. Failure and complication rates by three percutaneous approaches.

We prospectively studied the results of 714 attempts at central venous catheterization during an eight-month period in our intensive care department. We compared the rates of failure of catheterization and early complications among three percutaneous approaches: subclavian, anterior jugular, and posterior jugular veins. The procedures were performed by experienced staff or resident physicians and inexperienced interns and residents under teaching supervision. Overall rates of failure and complication were similar for each percutaneous approach within each group of physicians. Overall failure rate was 10.1% for the experienced group and 19.4% for the inexperienced. The complication was 5.4% for experienced and 11% for inexperienced. Among inexperienced physicians, the success rate was 86.7% and the complication rate 7.6% in unconscious patients, whereas in conscious patients these rates were 70.5% and 13.8%, respectively. The inexperienced physicians caused fewer complications in mechanically ventilated than in spontaneously breathing patients. We suggest that inexperienced physicians should first attempt central vein catheterizations in unconscious and mechanically ventilated patients.

[1]  A. Lockwood.  Percutaneous subclavian vein catheterization. Too much of a good thing? , 1984, Archives of internal medicine.

[2]  S. Bursztein,et al.  Unusual complications of subclavian vein catheterization , 1984, Critical care medicine.

[3]  M. Gorayeb.  Central venous catheterization in the emergency setting , 1984 .

[4]  E. Abraham,et al.  Central venous catheterization in the emergency setting , 1983, Critical care medicine.

[5]  A. Rotbart,et al.  Contralateral effusions secondary to subclavian venous catheters. Report of two cases. , 1983, Chest.

[6]  J. Gómez-Arnau,et al.  Internal jugular vein catheterization: time required with several techniques under different clinical situations. , 1983, Anesthesia and analgesia.

[7]  H. Tydén.  Cannulation of the Internal Jugular Vein ‐ 500 Cases , 1982, Acta anaesthesiologica Scandinavica.

[8]  D. Lebrec,et al.  Percutaneous cannulation of the internal jugular vein in patients with coagulopathies: an experience based on 1,000 attempts. , 1982, Anesthesiology.

[9]  J. Ruggiero,et al.  Central Venous Catheterization for Parenteral Nutrition , 1981, Annals of surgery.

[10]  D. Feliciano,et al.  Major Complications of Percutaneous Subclavian Vein Catheters , 1979 .

[11]  A. Schwartz,et al.  Two approaches to cannulation of a child's internal jugular vein. , 1979, Anesthesiology.

[12]  Johnson Fe.  Internal jugular vein catheterization. , 1978, New York state journal of medicine.

[13]  C. Herbst.  Indications, management, and complications of percutaneous subclavian catheters. An audit. , 1978, Archives of surgery.

[14]  P. Skovsted,et al.  Percutaneous Catheterization of the Internal Jugular Vein , 1978, Acta anaesthesiologica Scandinavica. Supplementum.

[15]  M. Salem,et al.  A new approach to percutaneous catheterization of the internal jugular vein. , 1977, Anesthesiology.

[16]  J. Malatinský,et al.  Misplacement and Loop Formation of Central Venous Catheters , 1976, Acta anaesthesiologica Scandinavica.

[17]  M. Rosen,et al.  Positioning central venous catheters through the basilic vein. A comparison of catheters. , 1973, British journal of anaesthesia.

[18]  J. Fleiss,et al.  Statistical methods for rates and proportions , 1973 .

[19]  A. Brinkman,et al.  Internal jugular venipuncture. , 1973, JAMA.

[20]  N. Shumway,et al.  Percutaneous internal jugular vein cannulation. , 1970, Archives of surgery.

[21]  G. Kenny,et al.  Safe placement of central venous catheter into internal jugular veins. , 1970, Archives of surgery.

[22]  Mahr Mm,et al.  Use of the internal jugular vein for placement of central venous catheter. , 1970 .

[23]  I. English.  Percutaneous catheterisation of the internal jugular vein , 1969 .

[24]  I. Gradisar,et al.  Air embolus--a lethal complication of subclavian venipuncture. , 1969, The New England journal of medicine.

[25]  C. S. Thomas,et al.  Pericardial tamponade from central venous catheters. , 1969, Anesthesia and analgesia.

[26]  B. Nerstrøm,et al.  Complications of percutaneous catheterization of the subclavian vein in 129 cases. , 1967, Acta chirurgica Scandinavica.

[27]  J. B. Grow,et al.  Central Venous Pressure in Optimal Blood Volume Maintenance , 1962 .