Risk factors for central venous catheter-related vascular erosions.
Risk factors for superior vena cava perforations following central venous catheterization for total parenteral nutrition were identified in a retrospective study of 1058 catheters in 853 patients; 540 of these catheters were size 16-gauge (51%) and 518 size 14-gauge (49%). Of the size 14-gauge catheters, 274 (53%) were right-sided and 244 (47%) were left-sided subclavian catheters. Four patients (0.4%) had superior vena cava perforation. All had left-sided large bore 14-gauge catheters. All patients experienced acute symptoms and all had pleural effusions. There was no mortality directly related to vascular erosions. Two risk factors were identified for this complication: (1) catheters originating from the left side (p less than 0.05), or (2) large catheters (size 14-gauge or larger) (p less than 0.01). We conclude that large bore or left-sided central venous catheter placement represents an increased risk of superior vena cava perforation.
Johns Hopkins Medical Institutions, Department of Surgery, Baltimore, Maryland.
L
L
Mukau
M A
MA
Talamini
J V
JV
Sitzmann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D012307:Risk Factors; D012421:Rupture; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging / Q000293:injuries*