Comparison of Complications in Patients with Central Venous Catheter Placement Via Internal Jugular, Subclavian and Femoral Route at Intensive Care Unit

Comparison of complications of CVC placement via different routes

Authors

  • Mohammad Haroon Bahria International Hospital, Rawalpindi, Pakistan
  • Ayesha Anwer Bahria International Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i07.381

Keywords:

Central venous catheter; Comparison; Complications; Intensive care unit

Abstract

Central venous lines are passed in almost all patients admitted in intensive care unit and a need still exist to look for best route for this purpose. Objective: To compare the complications in patients with central venous catheter passed via internal jugular, subclavian and femoral route at intensive care unit. Methods: A comparative cross-sectional study was conducted on 380 patients admitted in intensive care unit of Bahria International Hospital RWP from January 2022 to June 2022. Central venous catheters were passed by consultant critical care specialist on call at the time of reception of patient in unit. All the patients were observed for one week for presence of any local or systemic complications. Results: Out of 380 patients, 240 (63.2%) were male while 140 (36.8%) were female. Central venous catheter was passed via internal jugular vein in 220 (57.8%) patients, via subclavian route in 60 (15.8%) patients and via femoral route in 100 (26.3%) patients. Failed attempts were seen statistically significantly more in internal jugular route (p-value-0.041) while local cellulitis was seen more in femoral route (p-value-0.012). Conclusions: Internal Jugular vein was the route most commonly used for insertion of central venous catheter in patients admitted in our intensive care unit. Complications were seen more not very common in our setting. Failed attempts were more seen in internal jugular route while local cellulitis was seen more in femoral route.

References

Kiekkas P, Tzenalis A, Gklava V, Stefanopoulos N, Voyagis G, Aretha D. Delayed Admission to the Intensive Care Unit and Mortality of Critically Ill Adults: Systematic Review and Meta-analysis. Biomedical Research International. 2022 Feb; 2022(1): 4083494. doi: 10.1155/2022/4083494.

Reyes LF, Bastidas A, Narváez PO, Parra-Tanoux D, Fuentes YV, Serrano-Mayorga CC, et al. Clinical characteristics, systemic complications, and in-hospital outcomes for patients with COVID-19 in Latin America. LIVEN-Covid-19 study: A prospective, multicenter, multinational, cohort study. PLoS One. 2022 Mar; 17(3): e0265529. doi: 10.1371/journal.pone.0265529.

Seifu A, Eshetu O, Tafesse D, Hailu S. Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study. BMC Anesthesiology. 2022 Jan; 22(1): 13. doi: 10.1186/s12871-021-01556-7.

Tang R, Peng J, Wang D. Central Venous Pressure Measurement Is Associated with Improved Outcomes in Patients with or at Risk for Acute Respiratory Distress Syndrome: An Analysis of the Medical Information Mart for Intensive Care IV Database. Frontiers in Medicine. 2022 Mar; 9(3): 858838. doi: 10.3389/fmed.2022.858838.

Struck MF, Ewens S, Schummer W, Busch T, Bernhard M, Fakler JKM, et al. Central venous catheterization for acute trauma resuscitation: Tip position analysis using routine emergency computed tomography. The Journal of Vascular Access. 2018 Sep; 19(5): 461-6. doi: 10.1177/1129729818758998.

Safety Committee of Japanese Society of Anesthesiologists. Practical guide for safe central venous catheterization and management 2017. Journal of Anesthesia. 2020 Apr; 34(2): 167-86. doi: 10.1007/s00540-019-02702-9.

Kornbau C, Lee KC, Hughes GD, Firstenberg MS. Central line complications. International journal of critical illness and injury science. 2015 Jul; 5(3): 170-8. doi: 10.4103/2229-5151.164940.

Wong AV, Arora N, Olusanya O, Sharif B, Lundin RM, Dhaddaet A, et al. Insertion rates and complications of central lines in the UK population: A pilot study. Journal of the Intensive Care Society. 2018 Feb; 19(1): 19-25. doi: 10.1177/1751143717722914.

Deshpande KS, Hatem C, Ulrich HL, Currie BP, Aldrich TK, Bryan-Brown CW, et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Critical Care Medicine. 2005 Jan; 33(1): 13-235. doi: 10.1097/01.ccm.0000149838.47048.60.

Ahmed B, Khan IM, Beg MA. Frequency of Central Venous Catheter Related Infections and their Culture and Sensitivity Pattern. Journal of Islamabad Medical and Dental College. 2016 May; 5(2): 63-6.

Björkander M, Bentzer P, Schött U, Broman ME, Kander T. Mechanical complications of central venous catheter insertions: A retrospective multicenter study of incidence and risks. Acta anaesthesiologica Scandinavica. 2019 Jan; 63(1): 61-8. doi: 10.1111/aas.13214.

Devia Jaramillo G, Torres Castillo J, Lozano F, Ramírez A. Ultrasound-guided central venous catheter placement in the emergency department: experience in a hospital in Bogotá, Colombia. Open Access Emergency Medicine. 2018 May; 10(3): 61-5. doi: 10.2147/OAEM.S150966.

Sugiki D, Matsushima H, Asao T, Tokumine J, Lefor AK, Kamisasanuki T, et al. A web-based self-learning system for ultrasound-guided vascular access. Medicine (Baltimore). 2022 Oct; 101(43): e31292. doi: 10.1097/MD.0000000000031292.

Lenz H, Myre K, Draegni T, Dorph E. A Five-Year Data Report of Long-Term Central Venous Catheters Focusing on Early Complications. Anesthesiology Research Practice. 2019 Dec; 2019: 6769506. doi: 10.1155/2019/6769506.

Marik PE, Flemmer M, Harrison W. The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: a systematic review of the literature and meta-analysis. Critical Care Medicine. 2012 Aug; 40(8): 2479-85. doi: 10.1097/CCM.0b013e318255d9bc.

Kaur R, Mathai AS, Abraham J. Mechanical and infectious complications of central venous catheterizations in a tertiary-level intensive care unit in northern India. Indian Journal of Anaesthology. 2012 Jul; 56(4): 376-81. doi: 10.4103/0019-5049.100823.

Comerlato PH, Rebelatto TF, Santiago de Almeida FA, Klein LB, Boniatti MM, Schaan BD, et al. Complications of central venous catheter insertion in a teaching hospital. Revista da Associacao Medica Brasileira (1992). 2017 Jul; 63(7): 613-20. doi: 10.1590/1806-9282.63.07.613.

Akmal AH, Hasan M, Mariam A. The incidence of complications of central venous catheters at an intensive care unit. Annals of Thoracic Medicine. 2007 Apr; 2(2): 61-3. doi: 10.4103/1817-1737.32232.

Toor H, Farr S, Savla P, Kashyap S, Wang S, Miulli DE. Prevalence of Central Line-Associated Bloodstream Infections (CLABSI) in Intensive Care and Medical-Surgical Units. Cureus. 2022 Mar; 14(3): e22809. doi: 10.7759/cureus.22809.

Singh K, Bharti AK, Dubey PK. Use of 'Low approach' femoral central venous cannulation during COVID 19 pandemic. American Journal of Emerging Medicine. 2021 Nov; 49(3): 406-7. doi: 10.1016/j.ajem.2021.02.010.

Downloads

Published

2022-12-31
CITATION
DOI: 10.54393/pjhs.v3i07.381
Published: 2022-12-31

How to Cite

Haroon, M. ., & Anwer, A. . (2022). Comparison of Complications in Patients with Central Venous Catheter Placement Via Internal Jugular, Subclavian and Femoral Route at Intensive Care Unit: Comparison of complications of CVC placement via different routes. Pakistan Journal of Health Sciences, 3(07), 30–34. https://doi.org/10.54393/pjhs.v3i07.381

Issue

Section

Original Article

Plaudit