Intravascular Complications of Central Venous Catheterization by Insertion Site

Act, Abstr; Parienti, Jean‐Jacques; Mongardon, Nicolas; Mégarbane, Bruno; Mira, Jean‐Paul; Kalfon, Pierre; Gros, Antoine; Marqué, Sophie; Thuong, Marie; Pottier, Véronique; Ramakers, Michel; Savary, Benoît; Seguin, Amélie; Valette, Xavier; Terzi, Nicolas; Sauneuf, Bertrand; Cattoir, Vincent; Mermel, Leonard A.

doi:10.1056/nejmoa1500964

Cited by 523 publications

(263 citation statements)

References 41 publications

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“…In a recent publication, SV catheterization was associated with a lower risk of bloodstream infection and symptomatic thrombosis but a higher risk of pneumothorax than jugular or femoral vein catheterisation [52]. Whilst US-guided SV catheterisation largely avoids the risks of pneumothorax and arterial puncture, it requires more skill and training than the jugular approach by virtue of its anatomical location.…”

Section: Subclavian Vein (Sv)mentioning

confidence: 99%

Executive summary on the use of ultrasound in the critically ill: consensus report from the 3rd Course on Acute Care Ultrasound (CACU)

Malbrain¹,

Tavernier²,

Haverals³

et al. 2017

Anaesthesiol Intensive Ther

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Over the past decades, ultrasound (US) has gained its place in the armamentarium of monitoring tools in the intensive care unit (ICU). Critical care ultrasonography (CCUS) is the combination of general CCUS (lung and pleural, abdominal, vascular) and CC echocardiography, allowing prompt assessment and diagnosis in combination with vascular access and therapeutic intervention. This review summarises the findings, challenges lessons from the 3 rd Course on Acute Care Ultrasound (CACU) held in November 2015, Antwerp, Belgium. It covers the different modalities of CCUS; touching on the various aspects of training, clinical benefits and potential benefits. Despite the benefits of CCUS, numerous challenges remain, including the delivery of CCUS training to future intensivists. Some of these are discussed along with potential solutions from a number of national European professional societies. There is a need for an international agreed consensus on what modalities are necessary and how best to deliver training in CCUS.

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Section: Subclavian Vein (Sv)mentioning

confidence: 99%

Executive summary on the use of ultrasound in the critically ill: consensus report from the 3rd Course on Acute Care Ultrasound (CACU)

Malbrain¹,

Tavernier²,

Haverals³

et al. 2017

Anaesthesiol Intensive Ther

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“…Even without structured training, the incidence of mechanical complications is comparable with data published in the literature. 8,9 In turn, the rate of catheter infection in our institution is higher than reported in the foreign literature. 8,12,13 Arterial puncture, hematoma and pneumothorax are, in this order, the most common complications related to central venous punctures according to the literature.…”

Section: Discussionmentioning

confidence: 46%

“…8,9 In turn, the rate of catheter infection in our institution is higher than reported in the foreign literature. 8,12,13 Arterial puncture, hematoma and pneumothorax are, in this order, the most common complications related to central venous punctures according to the literature. 1,8,9 We point out in particular the fact that pneumothorax, a complication with greater morbidity, is rare, occurring in less than 1% of the jugular approaches and up to 1.5% of the subclavian approaches.…”

Section: Discussionmentioning

confidence: 46%

“…1 Infectious complications, in turn, appear more common in the femoral and jugular approach. 8 Other variables may also influence the rate of complications, such as the use of ultrasonography to guide the procedure, the time of the procedure and the amount of training of the professional performing it. 1 Considering the latter, there is no specific training in most Brazilian teaching hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Complications of central venous catheter insertion in a teaching hospital

Comerlato

Rebelatto

Almeida

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction: Central venous catheters are fundamental to daily clinical practice. This procedure is mainly performed by residents, often without supervision or structured training. Objective: To describe the characteristics of central venous catheterization and the complication rate related to it. Method: Retrospective cohort study. Adult patients undergoing central venous catheter insertion out of the intensive care unit (ICU) of a teaching hospital were selected from March 2014 to February 2015. Data were collected from medical charts using an electronic form. Clinical and laboratory characteristics from patients, procedure characteristics, and mechanical and infectious complications rates were assessed. Patients with and without complications were compared. Results: Three hundred and eleven (311) central venous catheterizations were evaluated. The main reasons to perform the procedure were lack of peripheral access, chemotherapy and sepsis. There were 20 mechanical complications (6% of procedures). Arterial puncture was the most common. Procedures performed in the second semester were associated with lower risk of complications (odds ratio 0.35 [95CI 0.12-0.98; p=0.037]). Thirty-five (35) catheter-related infection cases (11.1%) were reported. They were related to younger patients and procedures performed by residents with more than one year of training. Procedures performed after the first trimester had a lower chance of infection. Conclusion: These results show that the rate of mechanical complications of central venous puncture in our hospital is similar to the literature, but more attention should be given to infection prevention measures.

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“…Transfer of knowledge between the ICU and nephrology, e.g., during daily rounds, will undoubtedly improve the quality of care. For instance, nephrologists may draw attention to the long-term consequences of dialysis catheters in the subclavian vein [8], although ICU studies suggest this vein as the preferential site for catheter placement [9]. Nephrologists may suggest modifications to the intermittent dialysis procedure that promote hemodynamic stability, e.g., blood volume monitoring or sodium profiling [10,11].…”

Section: What Should Be the Role Of The Nephrologist In The Icu?mentioning

confidence: 99%