Central venous catheterisation - 3
The most common mechanical complications are :
- arterial puncture
- pneumothorax or haemothorax.
Mechanical complications and site of insertion
Generally, internal jugular and subclavian catheterisation carry similiar risks of mechanical complications.
Pneumo/haemothorax are more common in subclavian catheterisation, whilst arterial puncture is more likely to occur with internal jugular catheterisation.
Femoral catheterisation is more likely to be complicated by arterial puncture and haematoma.
Catheter related infections can occur from a number of different mechansims :
- infection of the exit site
- infection of the external catheter surface
- contamination of the catheter hub - leading to intraluminal colonisation
- hematogenous seeding of the catheter
In various trials, the subclavian site appears to have the lowest rate of infectious complications.
Any patient with a CVC line is at increased risk for catheter related thrombosis. Insertion into the subclavian veins seems to have the lowest risk of developing a thrombotic complication.