Risk factors for failure of subclavian vein catheterization: a retrospective observational study
Background and objectives
The aim of this study was to analyze risk factors for failure of subclavian vein catheterization.
A retrospective analysis of 1562 patients who underwent subclavian vein puncture performed by the same experienced operator at Peking University Cancer Hospital from January 1, 2016 to January 1, 2019 was conducted. The success or failure of subclavian vein catheterization was registered in all cases. Various patient characteristics, including age, gender, body mass index (BMI), preoperative hemoglobin, preoperative hematocrit, preoperative mean corpuscular hemoglobin concentration (MCHC), preoperative albumin, preoperative serum creatinine, puncture needles from different manufacturers and previous history of subclavian vein catheterization were assessed via univariate and multivariate analyses.
For the included patients, landmark-guided subclavian vein puncture was successful in 1476 cases and unsuccessful in 86 cases (success rate of 94.5%). Successful subclavian vein catheterization was achieved via right and left subclavian vein puncture in 1392 and 84 cases, respectively. In univariate analyses, age and preoperative hemoglobin were associated with failure of subclavian vein catheterization. In a multivariate analysis, aged more than 60 years was a risk factor while the central venous access with Certofix® was associated with an increased rate of success (p-values of 0.001 and 0.015, respectively).
This study has demonstrated that patient aged more than 60 years was a risk factor for failure of subclavian vein catheterization while the central venous access with Certofix® was associated with an increased rate of success.
 J. Merrer, B.D. Jonghe, F. Golliot, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial JAMA., 286 (2001), pp. 700-707
 A. Camkiran Firat, P. Zeyneloglu, M. Ozkan, et al. A randomized controlled comparison of the internal jugular vein and the subclavianvein as access sites for central venous catheterization in pediatric cardiac surgery Pediatr Crit Care Med., 17 (2016), pp. e413-e419
 J.J. Parienti, N. Mongardon, B. Mégarbane, et al. Intravascular complications of central venous catheterization by insertion site N Engl J Med., 373 (2015), pp. 1220-1229
 D.C. McGee, M.K. Gould Preventing complications of central venous catheterization N Engl J Med., 348 (2003), pp. 1123-1133
 H. Takeyama, M. Taniguchi, H. Sawai, et al. Limiting vein puncture to three needle passes in subclavian vein catheterization by the Infraclavicular approach Surg Today., 36 (2006), pp. 779-782
 P.F. Mansfield, D.C. Hohn, B.D. Fornage, et al. Complications and failures of subclavian-vein catheterization N Engl J Med., 331 (1994), pp. 1735-1738
 J.Y. Lefrant, L. Muller, J.E. De La Coussaye, et al. Risk factors of failure and immediate complication of subclavian vein catheterization in critically ill patients Intensive Care Med., 28 (2002), pp. 1036-1041
 A.V. Wong, N. Arora, O. Olusanya, et al. Insertion rates and complications of central lines in the UK population: A pilot study J Intensive Care Soc., 19 (2018), pp. 19-25
 M. Lamperti, A.R. Bodenham, M. Pittiruti, et al. International evidence based recommendations on ultrasound-guided vascular access Intensive Care Med., 38 (2012), pp. 1105-1117
 P. Frykholm, A. Pikwer, F. Hammarskjöld, et al. Clinical guidelines on central venous catheterisation Swedish Society of Anaesthesiology and Intensive Care Medicine Acta Anaesthesiol Scand., 58 (2014), pp. 508-524
 S. Griswold-Theodorson, E. Farabaugh, N. Handly, et al. Subclavian central venous catheters and ultrasound guidance: policy vs practice J Vasc Access., 14 (2013), pp. 104-110
 E. Gualtieri, S.A. Deppe, M.E. Sipperly, et al. Subclavian venous catheterization: greater success rate for less experienced operators using ultrasound guidance Crit Care Med., 23 (1995), pp. 692-697
 M. Fragou, A. Gravvanis, V. Dimitriou, et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study Crit Care Med., 39 (2011), pp. 1607-1612
 C.P. Lin, Y.C. Wang, F.S. Lin, et al. Ultrasound-assisted percutaneous catheterization of the axillary vein for totally implantable venous access device Eur J Surg Oncol., 37 (2011), pp. 448-451
 E.H. Kim, J.H. Lee, I.K. Song, et al. Real-time ultrasound-guided axillary vein cannulation in children: a randomised controlled trial Anaesthesia., 72 (2017), pp. 1516-1522