Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients.
Intensive Care Med
; 28(8): 1036-41, 2002 Aug.
Article
em En
| MEDLINE
| ID: mdl-12185422
ABSTRACT
OBJECTIVE:
To identify the risk factors of failure and immediate complication of subclavian vein catheterization (SVC).DESIGN:
Prospective observational study.SETTING:
Surgical critical care unit of a tertiary university hospital. PATIENTS Critically ill patients requiring a first SVC. INTERVENTION Subclavian vein catheterization was attempted in 707 patients without histories of surgery or radiotherapy in the subclavian area. Failed catheterizations, arterial punctures, pneumothoraces and misplacements of the catheter tip were recorded. Risk factors of failure and immediate complication were isolated among patients' characteristics, procedure parameters (side and number of venipunctures) and the operator's experience using a univariate +/- multivariate analysis. MEASUREMENTS AND MAINRESULTS:
Five hundred sixty-two SVCs (79.5%) were achieved without adverse events. Among the remaining 145 catheterizations, 67 (9.5%) failures, 55 (7.8%) arterial punctures, 22 (3.1%) pneumothoraces and 30 (4.2%) misplacements of the catheter tip occurred. More than one venipuncture was the only risk factor of failed catheterization [2 venipunctures, odds ratio =7.4 (2.1-26); >2 venipunctures, odds ratio =49.1 (16.8-144.1)]. More than one venipuncture and age 77 years or more were predictive of the occurrence of immediate complications [2 venipunctures, odds ratio =3.6 (1.8-7.0); >2 venipunctures, odds ratio =14 (7.7-25.3); age >or=77, odds ratio =1.8 (1.0-3.1)]. The operator's training was not predictive of failed catheterization or immediate complication.CONCLUSION:
For SVC, more than one venipuncture is predictive of failed catheterization and immediate complication. Age 77 years or more was predictive of immediate complications.
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Base de dados:
MEDLINE
Assunto principal:
Veia Subclávia
/
Cateterismo Venoso Central
/
Cuidados Críticos
/
Unidades de Terapia Intensiva
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Intensive Care Med
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
França