UMEM Educational Pearls

  • A recent trial looked at the three common sites for central venous catheters in 3471 catheter insertions
  • The primary outcome was a composite of catheter-related bloodstream infection and DVT
  • The femoral line group had a higher risk of DVT and infections although the risk from both is still very low
  • Pneumothorax occurred in 1.5% of subclavian lines and 0.5% of jugular lines
  • Subclavian lines are thought to have lower infection rates due to a longer subcutaneous courses before entry. They also have the lowest bacterial bioburden and tend to be protected against disruption

References

Parienti et al. INtravascular complications of central venous catherization by insertion site. N ENGL J MED 373;13. Sept 24, 2015