Limiting vein puncture to three needle passes in subclavian vein catheterization by the infraclavicular approach.

Abstract:

PURPOSE:With central venous catheterization, each additional vein puncture raises the risk of complications. We assessed the rate of failure and complications using a limiting rule whereby the number of needle passes for subclavian vein catheterization was restricted to three. METHODS:A prospective clinical trial was conducted between September 2001 and December 2003 in a university hospital surgical department. Two hundred and thirty-two adult patients were enrolled to undergo subclavian vein catheterization under non-emergency conditions. The patients were subjected to right subclavian vein catheterization by the infraclavicular approach. Vein puncture failure was defined as such if venipuncture was not accomplished after three attempts. Any arterial puncture was judged to be a failure immediately. RESULTS:Vein puncture failure occurred in nine patients (3.9%), and included two arterial punctures (0.9%). No other complications, such as pneumothorax, hemothorax, plexus lesion, mediastinal hematoma or bleeding, or air embolism, were observed. In multivariate analyses, a close to average body mass index (weight in kilograms divided by the square of the height in meters, odds ratio 0.74; 95% confidence interval 0.56-0.97; P = 0.028) was associated with a low risk of failure. CONCLUSION:Limiting the number of needle passes to three may therefore prevent mechanical complications. A low body mass index was predictive of vein puncture failure.

journal_name

Surg Today

journal_title

Surgery today

authors

Takeyama H,Taniguchi M,Sawai H,Funahashi H,Akamo Y,Suzuki S,Manabe T

doi

10.1007/s00595-006-3259-9

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

779-82

issue

9

eissn

0941-1291

issn

1436-2813

journal_volume

36

pub_type

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