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Serious
mechanical complications with the insertion of central venous catheter were
rare, however the complication rate is rare only if the procedure rests in good
hands.
A
large retrospective, multicenter, observational study of 10 949 central venous
catheter insertions demonstrated a lower risk of mechanical complications in
hospitalized patients. However, the incidence of mechanical complications can
be influenced by some additional risk factors.
The
central venous catheter is considered as a risk-free procedure as incidences of
mechanical complications during its insertion are very rare. Some of the
previously conducted small cohorts diagnosed some complications during central
venous catheter implementations. Malin Björkander and colleagues conducted a
multicenter observational study in a large group of patients to determine
central venous catheter-related risk factors and problems like mechanical complications.
The
data for analysis was included from 8 southern Sweden hospitals from the year
2013 to 2016. The information related to
use of ultrasonography, blood coagulation tests, number of needle passes, bore
size, central venous catheter location, the chronological order of the central
venous catheter insertion, mechanical complications and arterial puncture was
involved. Mechanical complications such as nerve injury, malignant arrhythmia,
pneumothorax and bleeding were considered as primary outcomes. Other
complications like persistent nerve injury, bleeding that needed transfusion or
treatment and non-self-limiting arrhythmia were marked as severe mechanical
issues of the central venous catheter.
Out
of 10949 catheter insertions, only 118 cases exhibited mechanical
complications. Eighty-five patients showed bleeding, 21 exhibited
pneumothoraces, 7 showed nerve injuries, and 5 showed self-limiting arrhythmia.
Only 23 cases reflected severe problems. Grade 2-4 bleeding was related to
arterial puncture, a number of needle passes and preprocedural coagulopathy
approaches and pneumothorax related to the chronological order of the central
venous catheter insertion, subclavian vein insertions and arterial puncture
modalities. Very few cases were noticed out of the large population, and this
shows central venous catheter is a safe insertion method.
Acta Anaesthesiologica Scandinavica
Mechanical complications of central venous catheter insertions: A retrospective multicenter study of incidence and risks
Malin Björkander et al.
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