Comparison of a Subclavian Vein Approach with a Peripheral VeinApproach in the Insertion of a Central Venous Catheter

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The purpose of this study was to evaluate the safety and usefulness of a peripheral vein approach when inserting a central venous catheter (CVC) as compared with a subclavian vein approach (infraclavicular approach). During the period April-July, 1998,a total of 51 patients (41 male, 10 female) underwent the insertion of central venous catheters by a subclavian vein or peripheral vein approach at Department of Surgery I, Niigata University Medical Hospital. A total of 59 cases received central venous cannulation : 41 cases (38 patients; 29 male, 9 female) by a subclavian vein approach, and 18 cases (17 patients; 16 male, one female) by a peripheral vein approach. Four patients experienced both approaches. Age, male-female ratio, body weight, underlying diseases, average number of days of catheterization, maximum calories administered, frequency of trials until successful insertion, frequency of complications, and rates of catheter related infection were compared between the two groups. Although the peripherally approached group experienced a significantly higher frequency of trials until successful insertion than the subclavian approached group (1.3±0.5 vs 1.1±0.4 : p<0.05), there were no significant differences in other factors between two groups. Serious complications such as pneumothorax or arterial puncture were significantly frequent in the CVC group as compared with the peripherally inserted central venous catheter (PICC) group (p<0.05). In conclusion, a peripheral vein approach proved less dangerous at insertion compared with a subclavian vein approach.
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Comparison of a Subclavian Vein Approach with a Peripheral VeinApproach in the Insertion of a Central Venous Catheter

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