Comments on: Complications of subclavian venopuncture http://www.unboundedmedicine.com/2005/12/28/complications-of-subclavian-venopuncture/ Thu, 11 Mar 2010 04:48:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Gerardo, M.D. http://www.unboundedmedicine.com/2005/12/28/complications-of-subclavian-venopuncture/#comment-60 Gerardo, M.D. Thu, 29 Dec 2005 05:07:47 +0000 http://www.unboundedmedicine.com/?p=42#comment-60 I Think it is a safe procedure but still has some riks. Even in experienced hands like any others invasive procedures. However for some indications could be not risk-benefit.A way to reduce the incidence of complications coud be to review its indications and the level of evidence to support its impact in mortality, reduction in hospitalization days, etc. In México nowdays in The Nationals Institutes of Helth the initial placement of a periferal access central line is the initial practice in most patients. I Think it is a safe procedure but still has some riks. Even in experienced hands like any others invasive procedures. However for some indications could be not risk-benefit.A way to reduce the incidence of complications coud be to review its indications and the level of evidence to support its impact in mortality, reduction in hospitalization days, etc. In México nowdays in The Nationals Institutes of Helth the initial placement of a periferal access central line is the initial practice in most patients.

]]> By: JonMikel, M.D. http://www.unboundedmedicine.com/2005/12/28/complications-of-subclavian-venopuncture/#comment-59 JonMikel, M.D. Thu, 29 Dec 2005 00:19:14 +0000 http://www.unboundedmedicine.com/?p=42#comment-59 I agree with you, it's safer to place an IJ line than a SC central line. I really like your step-by-step procedure. Just one thing, ultrasound guidance of SC catheterization was not beneficial. Please, read this: <a href="http://content.nejm.org/cgi/content/short/331/26/1735" rel="nofollow"> Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization.N Engl J Med. 1994;331:1735-8.</a> Regards, Jon Mikel Iñarritu, M.D. I agree with you, it’s safer to place an IJ line than a SC central line.

I really like your step-by-step procedure.

Just one thing, ultrasound guidance of SC catheterization was not beneficial. Please, read this:
Mansfield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization.N Engl J Med. 1994;331:1735-8.
Regards,
Jon Mikel Iñarritu, M.D.

]]> By: Clinical Cases and Images http://www.unboundedmedicine.com/2005/12/28/complications-of-subclavian-venopuncture/#comment-58 Clinical Cases and Images Wed, 28 Dec 2005 21:00:23 +0000 http://www.unboundedmedicine.com/?p=42#comment-58 IJ central line placement is generally safer than SC especially with ultrasound like SiteRite - check out the guides for IJ TLC placement <a HREF="http://note3.blogspot.com/2004/02/central-line-placement-with-ultrasound.html" rel="nofollow">with</a> and <a HREF="http://note3.blogspot.com/2004/02/central-line-placement-procedure-guide.html" rel="nofollow">without</a> ultrasound guidance. <a HREF="http://clinicalcases.blogspot.com/2004/02/complications-of-central-line.html" rel="nofollow">Other complications</a> of TLC are pneumothorax and arrhythmia. IJ central line placement is generally safer than SC especially with ultrasound like SiteRite – check out the guides for IJ TLC placement with and without ultrasound guidance.

Other complications of TLC are pneumothorax and arrhythmia.

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