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A Contemporary Assessment of Mechanical Complication Rates and Trainee Perceptions of Central Venous Catheter Insertion.
J Hosp Med. 2017 08;12(8):646-651
Authors: Heidemann L, Nathani N, Sagana R, Chopra V, Heung M
Abstract
BACKGROUND: Limited data exist regarding rates of mechanical complications of ultrasound-guided, nontunneled central venous catheters (CVC). Similarly, trainee perceptions surrounding CVC complications are largely unknown.
OBJECTIVES: To evaluate contemporary CVC mechanical complication rates, associated risk factors, and trainee perspectives.
DESIGN: A single-center retrospective review of CVC procedures between June 1, 2014, and May 1, 2015. Electronic survey distributed to internal medicine trainees.
SETTING: Intensive care units and the emergency department at an academic hospital.
MEASUREMENTS: Electronic health records of patients with CVC procedures were reviewed for complications. Demographic and procedural characteristics were compared for complicated vs uncomplicated procedures. Student t tests and chi-square tests were used to compare continuous and categorical variables, respectively.
RESULTS: Of the 730 reviewed records, 14 serious mechanical complications occurred due to pneumothorax (n = 5), bleeding (n = 3), vascular injury (n = 3), stroke (n = 1), and death (n = 2). Risk factors for complicated vs uncomplicated CVC placement included subclavian location (21.4% vs 7.8%,