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Supraclavicular Versus Infraclavicular Approach of Subclavian Vein Cannulation in ICU Patients

Balwinderjit Singh, Professor, Department of Anaesthesia, Punjab Institute of Medical Sciences, Jalandhar, Punjab 144006, India. , Asha Anand1 , Balwinderjit Singh2 , Iqbal Singh3 , Arwinderpal Singh4

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Indian Journal of Anesthesia and Analgesia 5(9):p 1482-1486, September 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.9

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Abstract

Background: Subclavian vein is generally preferred in ICU for central venous access. Infraclavicular and supraclavicular approaches are the two techniques of subclavian venous catheterisation. Infraclavicular approach to subclavian vein has been widely used. The supraclavicular approach is less often used though this approach of subclavian vein catheterisation has some distinct advantages. So aim of our study was to compare the supraclavicular and infraclavicular approaches of subclavian vein cannulation in terms of success rate and safety profile.

Methods: A total of 60 critically ill patients aged between 20-60 years of either sex admitted in ICU, where central venous catheterisation was indicated were enrolled in the study. Group I included 30 patients where right Subclavian vein cannulation was performed using Supraclavicular approach. Group II included 30 patients where right Subclavian vein cannulation was performed using Infraclavicular approach. The parameters recorded in the study included success rate of cannulation, number of attempts to cannulate the vein, time required to obtain the access and the various complications.

Statistically Analysis: The results of the study were compiled, tabulated and compared statistically using unpaired ttest and Pearson’s Chi-square test.

Results: The first attempt success rate in Group I (supraclavicular group) is significantally higher than in Group II (Infraclavicular group). The time required to access is also less in Group I ( supraclavicular) as compared to Group 11 (infraclavicular) and is statistically significant.

Conclusion: We concluded that supraclavicular approach has high first attempt success rate and also the time required to access is less as compared to infraclavicular approach.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.9

Keywords

ICU; Subclavian Vein; Supraclavicular Approach; Infraclavicular Approach.

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