Combs R, Maurer J, Chousleb E, Turner J

Language: Spanish
References: 18
Page: 387-389
PDF size: 37.43 Kb.

ABSTRACT

Objective: We undertook this study to determine the safety and efficacy of placing subclavian central venous catheters in the sitting position in mechanically ventilated patients.
Methods: This was a prospective nonrandomized study performed in an urban/university level I trauma center in northeastern U.S. Two hundred consecutive mechanically ventilated patients admitted to the Surgical Intensive Care Unit were enrolled in the study. The indications for central venous catheterization were monitoring, access, and total parenteral nutrition. All 200 lines were placed using the Seldinger technique with the head of the bed elevated to 30°, flexed at the hip. All lines were placed by experienced personnel. Potential complications were predicted by the operator placing the line prior to obtaining a control chest x-ray.
Results: The subclavian vein was successfully cannulated in all 200 patients. The right subclavian vein was used in 68 patients. No complications such as pneumothorax, hemothorax or air embolism were recorded; 197 central lines were placed in the correct position with three lines placed in the neck.
Conclusions: Placement of central venous catheters in the sitting position is safe and effective in mechanically ventilated patients. It avoids the detrimental effects of the supine position in critically ill patients.

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