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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2011;6(1):45-49.
Published online January 31, 2011.
Catheter malposition rate following right subclavian venous catheterization
Dong Jun Lee, Mun Chul Kim
Department of Anesthesiology and Pain Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. kmcan@paran.com
Abstract
BACKGROUND
Malposition of a central venous catheter may cause several complications such as poor function of the catheter or cardiac tamponade. This study was designed to determine the incidence of malposition after subclavian venous catheterization at the university hospital.
METHODS
We prospectively examined catheter locations from 367 subclavian vein catheterizations by an infraclavicular approach using postoperative chest X-rays to analyze the rate of catheter malposition.
RESULTS
Primary misplacement was observed in 29 cases (7.9%). Seventeen cases were located in the right internal jugular vein, 8 cases (2.2%) were located in the left subclavian vein, 2 cases (0.5%) were located inside the right atrium, 1 catheter (0.3%) was kinking in the right subclavian vein and 1 catheter (0.3%) was located in the right brachiocephalic vein.
CONCLUSIONS
Using the infraclavicular approach for subclavian catheterization, a central venous catheter was most commonly misplaced in the ipsilateral internal jugular vein. Operators must keep in mind that even experienced practitioners may cause a considerable number of malpositions and it is very important to check the chest X-ray to locate the catheter malposition after central venous catheterization.
Key Words: Catheterization, Central venous, Malposition
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