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- Title
Impact of insertion site on complications in central venous access devices.
- Authors
Mansfield, Sara A.; Staszak, Jessica; Murphy, Andrew J.; Talbot, Lindsay; Abdelhafeez, Abdelhafeez; Prajapati, Hasmukh; Gold, Robert; Maller, Vinod; Proctor, Kimberly; Davidoff, Andrew M.; Williams, Regan F.
- Abstract
Purpose: There is still debate over the safest route for the placement of long-term central venous access devices. The aim of this study was to review a large, single-institution experience to determine the impact of access location on peri-operative complications. Methods: The records of patients undergoing subcutaneous port (SQP) and tunneled catheter insertion over a seven-year period were reviewed. Vein cannulated (subclavian (SCV) versus internal jugular (IJ) vein), and 30-day complications were assessed. Surgical complications included pneumothorax, hemothorax, infections, arrhythmia or malpositioning requiring intervention. Results: A total of 1,309 patients were included (618 SQP, 691 tunneled catheters). The location for insertion was SCV (909, 69.4%) and IJ (400, 30.6%). There were 69 complications (5.2%) (41, 4.5% SCV, 28, 7.0% IJV) including: malpositioning/malfunctioning (SCV 13, 1.4% and IJV 14, 3.0%), pneumothorax (SCV 4, 0.4% and IJV 1, 0.3%), hemothorax (SCV 0 and IJV 1, 0.3%), arrhythmia (SCV 1, 0.1%, and IJV 0), and infection within 30 days of placement (SCV 20, 2.2% and IJ 11, 2.8%). The complication rates were not significantly different based on site (p = 0.080). Conclusion: There was no significant difference in complication rates when using the subclavian versus the internal jugular vein as the site for long-term central venous access. Level of evidence: III, retrospective comparative study.
- Publication
Pediatric Surgery International, 2023, Vol 39, Issue 1, p1
- ISSN
0179-0358
- Publication type
Article
- DOI
10.1007/s00383-023-05399-w