Document Detail

Is the landmark technique safe for the insertion of subclavian venous lines?
MedLine Citation:
PMID:  16121775     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The complications of central venous line insertion have been highlighted by the recent NICE report advising that ultrasound guidance should be used for central line insertion. METHODS: We report a prospective audit of the complications of subclavian vein central venous line insertion for parenteral nutrition over a five-year period when ultrasound guidance was not used. RESULTS: In total, 201 lines were inserted for parenteral nutrition into a subclavian vein. A single consultant surgeon inserted 120 of the lines and year five or six surgical registrars performed the other line insertions. Five pneumothoraces occurred in four patients who had subclavian lines inserted and a chest drain was required in three cases. Four line tips were found to be going upwards rather than into the superior vena cava. Misplacement was more common with right subclavian insertion. Inability to site the line at that attempt was associated with previous line insertion in four of six patients. CONCLUSION: A low complication rate can be achieved for central line insertion for parenteral nutrition. It is likely that this is due to the small number of experienced operators.
J E M Crozier; R F McKee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland     Volume:  3     ISSN:  1479-666X     ISO Abbreviation:  Surgeon     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-26     Completed Date:  2005-09-22     Revised Date:  2006-08-01    
Medline Journal Info:
Nlm Unique ID:  101168329     Medline TA:  Surgeon     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  277-9, 305     Citation Subset:  IM    
University Department of Surgery, Glasgow Royal Infirmary, Glasgow, Scotland.
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MeSH Terms
Catheterization, Central Venous / methods*
Parenteral Nutrition / instrumentation
Postoperative Complications / etiology
Prospective Studies
Subclavian Vein*
Comment In:
Surgeon. 2006 Jun;4(3):188; author reply 188   [PMID:  16764211 ]
Surgeon. 2006 Jun;4(3):188; author reply 188   [PMID:  16764212 ]

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