ORIGINAL ARTICLE
MISPLACEMENTS OF CENTRAL VENOUS CATHETERS: INTERNAL JUGULAR VERSUS SUBCLAVIAN ACCESS IN CRITICAL CARE PATIENTS
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1
Yüzüncü Yıl University Medical School, Department of Anesthesiology and Reanimation, Van, Turkey
2
Yüzüncü Yıl University Medical School, Department of Chest Diseases, Van, Turkey
3
Yüzüncü Yıl University Medical School, Department of Radiology, Van, Turkey
Online publication date: 2007-07-15
Publication date: 2007-07-15
Corresponding author
Murat Tekin
Arastirma Hastanesi, Anesteziyoloji ve Reanimasyon
AD–Van/Turkey
Tel: 904322122651, Fax: 904322122651
Eur J Gen Med 2007;4(3):123-127
KEYWORDS
ABSTRACT
Aim; In central venous catheterization (CVC), misplacement is not a rare complication since
this is a blinded procedure. The aim of this study was to compare the misplacement risks of the
access of internal jugular vein with that of subclavian vein catheterizations.
Methods;The records of a total of 1092 patients in whom central venous catheters were
placed between 2002 and 2006 in Anesthesiology Intensive Care Unit and the location of the tips
was confirmed radiologically were retrospectively evaluated. Neck and infraclavicular region
were cleaned by antiseptic solution after routine monitorization. CVC were easily inserted with
Seldinger’s technique after blood aspiration through internal jugular vein or subclavian vein.
Results; In adult patients, six internal jugular catheter misplacements were seen (0.80%);
among them five were kinking and one was intrapleural location of the catheter tip. Six
subclavian misplacements (2.02 %) were detected, five of them were located in contralateral
subclavian vein, and one was located in ipsilateral internal jugular vein. In children, two
subclavian misplacements were seen as crossing to contraleteral subclavian vein, and there were
no internal jugular misplacement. There was no statistically difference for misplacement between
the access sites (in adult p= 0.110, in children p=0.501).
Conclusion; We have concluded that experience of operator should be taken into account for
choice of catheterization site.