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Mechanical Complications of Central Venous Catheters
Lewis A. Eisen, MD
Beth Israel Medical Center, Pulmonary Division, 7 Dazian, 17th Street at 1st Avenue, NY, NY 10010; leisen{at}gmail.com
Mangala Narasimhan, DO
Division of Pulmonary and Critical Care, Beth Israel Medical Center, New York, New York
Jeffrey S. Berger, MD
Department of Internal Medicine, Beth Israel Medical Center, New York, New York
Paul H. Mayo, MD
Mark J. Rosen, MD
Division of Pulmonary and Critical Care, Beth Israel Medical Center, New York, New York
Roslyn F. Schneider, MD
Department of Internal Medicine, Beth Israel Medical Center, New York, New York
We analyzed 385 consecutive central venous catheter (CVC) attempts over a 6-month period. All critically ill patients 18 years of age or older requiring a CVC were included. The rate of mechanical complications not including failure to place was 14%. Complications included failure to place the CVC (n = 86), arterial puncture (n = 18), improper position (n = 14), pneumothorax (n = 5 in 258 subclavian and internal jugular attempts), hematoma (n = 3), hemothorax (n = 1), and asystolic cardiac arrest of unknown etiology (n = 1). Male patients had a significantly higher complication rate than female patients (37% vs 27%, P = .04). The subclavian approach had a higher complication rate than the internal jugular or the femoral approach (39% vs 33% vs. 24%, P = .02). The complication rate increased with the number of percutaneous punctures, with a rate of 54% when more than 2 punctures were required.
Key Words: central venous catheterization • complications • critical care • pneumothorax • education
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Journal of Intensive Care Medicine, Vol. 21, No. 1,
40-46 (2006)
DOI: 10.1177/0885066605280884
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