title: Short-term femoral vein catheterization rarely causes thrombosis or bacteremia.
abstract: BACKGROUND
  Experts and national regulatory bodies have deemed femoral vein catheterization (FVC) unsafe, and recommend avoiding it whenever possible.
  
  
  OBJECTIVE
  To assess rates of catheter-related bloodstream infections (CRBI) and deep venous thrombosis (DVT) complicating FVC.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Medical intensive care unit (MICU) of a 350-bed community teaching hospital.
  
  
  METHODS
  Consecutive admissions to the MICU during 7 months.
  
  
  METHODS
  Demographic, laboratory and Doppler ultrasound studies were collected on patients receiving large vein catheters (VC) in our MICU. Ultrasound examinations were systematically performed on the day of and 5 to 7 days after removal of FVC.
  
  
  RESULTS
  VC were inserted in 238 (35% of) patients. Of that total, 217 catheters were in large veins (49% FVC, 38% internal jugular and 13% subclavian) for an average of 2.7 days for femoral, 5.7 days for internal jugular and 3.6 days for subclavian vein catheters. During 1200 catheter-days, no central VC CRBI was identified. Of 107 FVC, initial and follow-up Doppler studies were performed in 50 patients. A total of 97% of patients received routine thromboprophylaxis and none had a DVT. Of the 57 patients with initial but no Doppler follow-up at 5 to 7 days following removal, no patient developed clinically detected venous thromboembolism (VTE).
  
  
  CONCLUSIONS
  Short-term FVC was used safely in our MICU in the setting of thromboprophylaxis. In light of its favorable safety profile for initial resuscitation of critically ill patients, it may be premature to strongly discourage FVC.
authors.affiliation: Bridgeport Hospital, Bridgeport, Connecticut, USA.
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Casanegra
authors.forename: Scott
authors.initials: S
authors.lastname: Brannan
authors.forename: Ramona
authors.initials: R
authors.lastname: Dadu
authors.forename: Philip
authors.initials: P
authors.lastname: Ong
authors.forename: Mitchell
authors.initials: M
authors.lastname: Berner
authors.forename: Kristopher
authors.initials: K
authors.lastname: Spinning
authors.forename: Terence
authors.initials: T
authors.lastname: Hughes
authors.forename: Greg
authors.initials: G
authors.lastname: Marrinan
authors.forename: Kenneth
authors.initials: K
authors.lastname: Zinn
authors.forename: Constantine
authors.initials: C
authors.lastname: Manthous
mesh_terms: D016470:Bacteremia / Q000209:etiology*; D055499:Catheter-Related Infections; D002404:Catheterization / Q000009:adverse effects*; D015331:Cohort Studies; D005268:Femoral Vein; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D011446:Prospective Studies; D013997:Time Factors; D020246:Venous Thrombosis / Q000209:etiology*