title: Safety of percutaneous internal jugular catheterization in cancer patients: prospective observational study.
abstract: OBJECTIVE
  To determine predictors for failure and early complications of percutaneous internal jugular catheterization (IJC) in cancer patients.
  
  
  METHODS
  Six hundred and thirty consecutive cancer patients who required central venous catheterization were included in a prospective observational study. The rates of failure (defined as the intervention of a second physician and/or failure at initial insertion site) and of early complications were prospectively ascertained. Logistic regression analysis estimated odds ratio (OR) and 95% confidence intervals (95% CI) for independent predictors for failure and early complications of percutaneous IJC.
  
  
  RESULTS
  The failure rate was 6.7%, and the early complication rate was 6.7%. In multivariate analysis, left-side initial catheterization (p<0.01), prior catheterization at the same site (p=0.001) and physician inexperience (p<0.0001) were independently associated with failure. Placement requiring more than one needle pass (p<0.01 for two and p<0.0001 for three and more) and absence of fluoroscopy (p<0.0001) were independently associated with early complications.
  
  
  CONCLUSIONS
  Percutaneous IJC is a valid option in the central venous catheterization of cancer patients due to its reliability and safety. Skilled physicians must manage difficult placements. If placement requires more than one needle pass or is made without fluoroscopy, patients must be carefully followed for potential complications.
authors.affiliation: Department of Public Health, Léon Bérard Center, Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Gambotti
authors.forename: D
authors.initials: D
authors.lastname: Pérol
authors.forename: B
authors.initials: B
authors.lastname: Frering
authors.forename: P
authors.initials: P
authors.lastname: Kaemmerlen
authors.forename: B
authors.initials: B
authors.lastname: Coronel
authors.forename: H
authors.initials: H
authors.lastname: Sebban
authors.forename: V
authors.initials: V
authors.lastname: Bulso
authors.forename: V
authors.initials: V
authors.lastname: Bachelot
authors.forename: F
authors.initials: F
authors.lastname: Chauvin
authors.forename: P
authors.initials: P
authors.lastname: Bachmann