Central venous catheterisation - 3

Mechanical complications

The most common mechanical complications are :

- arterial puncture
- haematoma
- 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. 

Infectious complications

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.     

Thrombotic 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. 

Quiz Question 3

 

Which of the following is unlikely to cause a catheter related infection:

1) infection of the exit site .

2) colonisation of the inside of the catheter.

3) colonisation of the tip of the catheter.

4) contamination of the catheter hub .

5) infection at peripheral iv site.

 

Show answer

 

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