Mechanical Complications Following Central Venous Catheterisation in A Tertiary Care Teaching Institute: A Prospective Observational Study

Abstract

Background: Central venous catheters are an indispensablecomponent of current day critical care and are employedfor various indications. Central venous catheterizations(landmark-based or ultrasound-guided) are associated withmechanical complications. This study aimed to assess, analyzeand compare the complication rate between two commonlyemployed catheterization routes: Internal jugular vein andsubclavian vein.Methodology: A prospective, observational study comparingtwo landmark-based central venous catheterization techniqueswas planned in a tertiary care teaching institute. 100 patientsrequiring central venous catheterizations were enrolledalternately into the IJV and Subclavian groups. Standardlandmark-based insertion techniques were employed understrict asepsis. All patients were observed for mechanicalcomplications in the first 24 hours following catheterization.Statistical analysis was done using the statistical packageSPSS 20.0. Data were expressed as either mean and standarddeviation or numbers and percentages. Categorical variableswere analyzed using proportions and percentages. Associationbetween categorical variables was established by Chi-squareand odds ratio (OR) with 95% confidence intervals (CI).Results: There were 22 complications observed. Incidence ofcomplications was higher in the IJV group with 17 complicationsversus 5 in Subclavian group. There were 4 major complicationsand 18 minor complications between the two groups. Majorcomplications comprised of hematoma formation (7/22) andarterial puncture (8/22). Incidence of complication was alsoanalyzed with regards to independent variables.Conclusion: Mechanical complications following centralvenous catheterizations was found in both groups studied.Internal jugular venous group had a higher mechanicalcomplication rate than the subclavian group. Ultrasoundguidance and greater detail in delineating the anatomy arelikely to reduce the complication rates.