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Indian Journal of Anesthesia and Analgesia

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Mechanical Complications during Insertion of Central Venous Catheter in Subclavian Vein and Internal Jugular Vein: A Comparative Study

Rajashekar S., Assistant Professor, Department of Anaesthesia, Dr. V. M. Government Medical College, Solapur, Maharashtra 413003. , Sayandeep Mandal1 , Rajashekar S.2 , Kulkarni V.V.3 , Pushpa I. Agrawal4

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Indian Journal of Anesthesia and Analgesia 5(3):p 473-478, March 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.20

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Abstract

Background: Central venous catheters (CVC) are an essential component of modern critical care. They allow delivery of medications, intravenous fluids, parenteral nutrition, hemodialysis and monitoring of hemodynamic variables. Thus, percutaneous placement of a catheter into a central vein is a frequent procedure in many clinical settings. Aims: To compare the ease of insertion between Internal jugular vein (IJV) and Subclavian vein (SCV) catheterisation, frequency of mechanical complications between the two routes like- Arterial puncture, Pneumothorax, Hemothorax/Hydrothorax, Subcutaneous hematoma, Misplacement of catheter. Materials and Methods: 100 patients admitted to The Trauma Care Unit of our institution requiring CVC divided into two groups of 50 each. Group A Patients had CVC via IJV and Group B Patients had CVC via SCV. A prospective randomized double blinded clinical study has been conducted in patients of either sex fulfilling the inclusion and exclusion criteria after taking ethical committee approval and informed consent from the patients. The data was analysed using statistical methods like Chi square test, independent samples T test. Results: The age, sex in the two groups were found to be comparable. Ijv catheterisation was significantly easier than scv (P value <0.05) and the mechanical complication like pneumothorax and misplacement of catheter was less in Ijv (P value <0.05) compared to scv although arterial puncture, subcutaneous hematoma more in scv (P value <0.05) than Ijv. Conclusion: According to the observations and analysis of this study, catheterisation in IJV was significantly easier than SCV and has significantly lower risk of catheterisation related complications.

 

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.20

Keywords

Central Venous Catheters; Internal Jugular Vein (IJV); Subclavian Vein (SCV); Mechanical Complications. 

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