Superiority of the Internal Jugular over the Subclavian Access for Temporary Dialysis

Cimochowski, George E.; Worley, Edward; Rutherford, W. E.; Sartain, JoAnn; Blondin, Joan; Harter, Herschel R.

doi:10.1159/000185837

Cited by 372 publications

(173 citation statements)

References 11 publications

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“…In the study from Iran, type of central vein and side of catheterization had no effect on stenosis (7). But in another study (8), long term stricture of subclavian catheter was significantly higher than internal jugular vein and differed from most of the studies (2,3). In the study by Schillinger et al, on 100 cases (50 subclavian and 50 internal jugular), there was a significantly higher stenosis rate in subclavian (42%) compared to 10% of the internal jugular route (9).…”

Section: Discussionmentioning

confidence: 66%

Comparison of results of placement of cuffed –tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis

Zafarghandi

Nazari

Taghavi

et al. 2013

Polish Journal of Surgery

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4aim of the study was to comparison between internal jugular vs. subclavian vein cuffed tunnel catheter placement for dialysis. material and methods. Cases who required central venous catheter for dialysis were included in this study. Forty cases were included in this study and divided to two groups. Catheters were placed randomly in internal jugular vein or subclavian. Patients were followed for 6 months. Early and late complications of catheter's placement were recorded. Analysis was done using Spss ver 13.0 (Chicago, IL, USA). results. There were no significant differences between subclavian and internal jugular vein regarding occurrence of infection resulted in extraction or treatment. Also there were no significant differences regarding occurrence of thrombosis resulted in extraction or treatment. Failure rate was significantly higher in cases with internal jugular vein catheter compared to cases with subclavian vein catheter (p=0.04). conclusion. Failure rate was significantly higher in cases with internal jugular vein catheter compared to subclavian cathether. Subclavian catheter is more appropriate route for catheter placement.

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Section: Discussionmentioning

confidence: 66%

Comparison of results of placement of cuffed –tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis

Zafarghandi

Nazari

Taghavi

et al. 2013

Polish Journal of Surgery

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“…Category IA C. No recommendation can be made for a preferred site of insertion to minimize infection risk for a tunneled CVC [61][62][63]. Unresolved issue D. Place catheters used for hemodialysis and pheresis in a jugular or femoral vein rather than a subclavian vein to avoid venous stenosis if catheter access is needed [259][260][261][262][263]. Category IA IV.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

631

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…Few studies have provided data on the association between CVL body side, 8,[10][11][12][13][14][15] CVL vein location, 14,[16][17][18][19][20] or CVL insertion technique 15,21 with the incidence of VTE. Results from these studies are inconsistent or even contradictory, probably because of differences in study design, selection of study populations, and outcome assessment.…”

Section: Introductionmentioning

confidence: 99%

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

Male

Chait

Andrew

et al. 2003

Blood

220

164

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Venous thromboembolic events (VTEs) in children are associated with central venous lines (CVLs). The study objective was to assess whether CVL location and insertion technique are associated with the incidence of VTE in children. We hypothesized that VTE would be more frequent with (1) CVL location on the left body side, (2) CVL location in the subclavian vein rather than the jugular vein, and (3) CVL insertion by percutaneous technique rather than venous cut-down. This was a prospective, multicenter cohort study in children with acute lymphoblastic leukemia who had a CVL placed in the upper venous system during induction chemotherapy. Characteristics of CVL were documented prospectively. All children had outcome assessment for VTE by objective radiographic tests, including bilateral venography, ultrasound, echocardiography, and cranial magnetic resonance imaging. Among 85 children, 29 (34%) had VTE; 28 VTEs appeared in the upper venous system, and 1 was sinovenous thrombosis. Left-sided CVL (odds ratio [OR], 2.5; 95% confidence interval, 1.0-6.4; P ‫؍‬ .048), subclavian CVL (OR, 3.1; 95% CI, 1.2-8.5; P ‫؍‬ .025), and percutaneous CVL insertion (OR, 3.5; 95% CI, 1.3-9.2; P ‫؍‬ .011) were associated with an increased incidence of VTE. Interaction occurred between CVL vein location and insertion technique. Subclavian vein CVL inserted percutaneously had an increased incidence (54%) of VTE compared with any other combination (P ‫؍‬ .07). For CVL in the upper venous system, CVL placement on the right side and in the jugular vein may reduce the risk for CVL-related VTE. If subclavian vein placement is necessary, CVL insertion by venous cutdown appears preferable over percutaneous insertion.

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Superiority of the Internal Jugular over the Subclavian Access for Temporary Dialysis

Cited by 372 publications

References 11 publications

Comparison of results of placement of cuffed –tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis

Comparison of results of placement of cuffed –tunneled hemodialysis catheter in internal jugular vein with subclavian vein for long -term dialysis

Guidelines for the prevention of intravascular catheter-related infections

Central venous line–related thrombosis in children: association with central venous line location and insertion technique

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