Mechanical complications of central venous catheters.
We analyzed 385 consecutive central venous catheter (CVC) attempts over a 6-month period. All critically ill patients 18 years of age or older requiring a CVC were included. The rate of mechanical complications not including failure to place was 14%. Complications included failure to place the CVC (n = 86), arterial puncture (n = 18), improper position (n = 14), pneumothorax (n = 5 in 258 subclavian and internal jugular attempts), hematoma (n = 3), hemothorax (n = 1), and asystolic cardiac arrest of unknown etiology (n = 1). Male patients had a significantly higher complication rate than female patients (37% vs 27%, P = .04). The subclavian approach had a higher complication rate than the internal jugular or the femoral approach (39% vs 33% vs. 24%, P = .02). The complication rate increased with the number of percutaneous punctures, with a rate of 54% when more than 2 punctures were required.
Eisen
Lewis A
LA
Beth Israel Medical Center, Pulmonary Division, 7 Dazian, 17th Street at 1st Avenue, NY, NY 10010, USA. leisen@gmail.com
Narasimhan
Mangala
M
Berger
Jeffrey S
JS
Mayo
Paul H
PH
Rosen
Mark J
MJ
Schneider
Roslyn F
RF
D000368:Aged; D001158:Arteries / Q000293:injuries; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation / Q000706:statistics & numerical data*; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000706:statistics & numerical data; D005260:Female; D006406:Hematoma / Q000209:etiology; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011030:Pneumothorax / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D017211:Treatment Failure; D014950:Wounds, Penetrating / Q000209:etiology