Safety Study of Subclavian and Internal Jugular Venous Catheterization

A Randomize Controlled Trial to Compare the Complications of Subclavian and Internal Jugular Venous Catheterization in Critically Ill Patients

There is no randomized controlled trial to compare the rates of complications associated with internal jugular and subclavian venous catheterization. The aim of this study is to compare mechanical, infectious, and thrombotic complications of internal jugular and subclavian venous catheterization. An improved understanding of CVC-related risks might help clinicians to choose one approach over the other in specific clinical settings.

Central venous catheterization is often necessary to treat critically ill patients hospitalized in intensive care units (ICUs). However, this procedure may lead to serious and sometimes life-threatening complications, including mechanical, infectious, or thrombotic complications. The choice of insertion site can influence the incidence and type of such complications. The most frequently used sites for CVC insertion are the internal jugular and the subclavian vein. However, in an individual patient, criteria for choosing one approach over the other remain unclear.

Inclusion Criteria:

• admission to ICU
• requiring central venous catheterization
• without contraindications to attempt both jugular and internal jugular access

Exclusion Criteria:

• the presence of a central venous catheter at admission
• central venous catheterization within 2 weeks prior to admission
• emergency catheterization for a life-threatening situation
• major blood coagulation disorders
• anatomic defect precluding catheterization at either site
• skin lesions or recent surgery at either site