왼쪽 빗장밑정맥을 이용한 중심정맥도관술에서 중심정맥도관의 위치이상의 빈도와 숙련도와의 관계

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. (Anesth Pain Med 2011; 6: 45∼49) KCI Citation Count: 0