Catheter-related infections following axillary vein catheterization.
BACKGROUND
The aim of this study was to determine the rate of infectious complications following axillary vein cannulation and to compare to that observed after internal jugular vein catheterization.


METHODS
A prospective comparative open study was carried out to determine the rate of infectious complications related to the use of catheters inserted via the axillary vein or the internal jugular vein. During the study period all patients submitted to central venous catheterization were evaluated. A total of 141 patients entered and completed the study. Catheter insertion sites were either the axillary vein punctured in the axilla, or the internal jugular vein punctured using an anterior approach. Catheter tips were cultured using a quantitative technique. Clinical information pertaining to the analysis was prospectively collected.


RESULTS
A total of 141 catheters from 141 patients entered was studied. Clinical characteristics and risk factors for catheter infection were similar in both groups. The incidence of catheter-related infection (including catheter-related sepsis, and bacteremia) was not different between the two groups (axillary vein: 8.1%; internal jugular vein: 7.6%). Catheter-related bacteremia were seen at a rate of 3.7% in the internal jugular vein group and a rate of 1.6% in the axillary vein group (NS). The incidence of catheter colonization was similar in both groups (axillary vein: 14.5%; internal jugular vein: 11.4%).


CONCLUSIONS
Catheter-related infection after axillary vein catheterization was similar to that observed after internal jugular vein catheterization. The chance of developing catheter-related sepsis was less than 10% with either route when catheters were used for the treatment of severely ill patients.
Martin
C
C
Department of Intensive Care and Trauma Center, Nord Hospital, Marseilles, France.
Bruder
N
N
Papazian
L
L
Saux
P
P
Gouin
F
F
D000704:Analysis of Variance; D001367:Axillary Vein; D016470:Bacteremia / Q000209:etiology; D001424:Bacterial Infections / Q000209:etiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000451:nursing; D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000451:nursing; D003422:Critical Care; D016638:Critical Illness; D004202:Disinfectants / Q000627:therapeutic use; D004866:Equipment Contamination; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000209:etiology; D006801:Humans; D015994:Incidence; D007601:Jugular Veins; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology; D013203:Staphylococcal Infections / Q000209:etiology; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology
D004202:Disinfectants