Intravascular Complications of Central Venous Catheterization by Insertion Site

Patients in the ICU were assigned to catheter insertion in the subclavian, jugular, or femoral vein. Subclavian catheterization had a lower risk of bloodstream infection and deep-vein thrombosis, and a higher risk of pneumothorax, than catheterization in the other two sites. Subclavian, jugular, and femoral central venous catheterization are associated with infectious, thrombotic, and mechanical complications. 1 Catheter-related bloodstream infection has a significant effect on morbidity, mortality, and health care costs. 2 – 4 The risk of short-term catheter-related bloodstream infection is influenced mainly by extraluminal microbial colonization of the insertion site, 5 and such colonization is also associated with thrombosis. 6 , 7 Although the importance of catheter-related deep-vein thrombosis has been debated, 1 all thromboses have the potential to embolize. In addition, catheter-related deep-vein thrombosis 7 – 9 and pulmonary embolism 10 may remain undiagnosed in critically ill patients undergoing mechanical ventilation. 11 We conducted the 3SITES multicenter study to . . .