Man, B.; Kraus, L.
November 1973
Angiology;Nov1973, Vol. 24 Issue 10, p649
Academic Journal
Experience with the management of 695 cases of subclavian vein catheterizations is presented. The method provides prompt and reliable access to the central venous system. It is particularly useful for infusions in patients with peripheral circulatory collapse who require the rapid administration of large amounts of blood and fluids; for monitoring of the central venous pressure; and in patients requiring long term intravenous therapy. In experienced hands the procedure is simple, quick and can be performed in the ward. It is invaluable in situations where other veins are not available. Complications, some of them serious, like pneumothorax, haemothorax and haemomediastinum can be avoided if the procedure is performed by experienced personnel aware of the potential danger. The complications in our series were not serious: two cases of pneumothorax, ten cases of subcutaneous haematoma, five cases of false positioning of the catheter, and two cases of momentary subclavian artery penetration. There were no serious septic complications in our cases; contamination of the entrance site of the catheter was in 48 per cent of the cases and the withdrawn tip was infected in 44 per cent. The aspirated blood in all tested cases was sterile. No convincing relationship was found between the duration of infusion and the infection rate. According to cases reported in the literature, as well as our own experience, the complication rate was related to lack of expertise. It would appear that where personnel experienced in the method is available, complications are rare and unimportant.


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