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Subclavian Vein Catheterization Beats Jugular Femoral Placement

Reduces risk of blood infection, deep-vein thrombosis among critically ill

THURSDAY, Sept. 24, 2015 (HealthDay News) -- For patients in intensive care units who need a catheter, placement in the subclavian vein appears to lower the risk of bloodstream infection and deep-vein thrombosis, compared to jugular or femoral placement, a new study finds. The report was published in the Sept. 24 issue of the New England Journal of Medicine.

For the study, researchers randomly assigned 3,027 patients to have catheters placed in one of three locations: nontunneled central venous catheterization to the subclavian, jugular, or femoral vein. The primary outcome measure was a composite of catheter-related bloodstream infection and symptomatic deep-vein thrombosis.

The researchers found subclavian-vein catheterization was associated with a lower risk of bloodstream infection and symptomatic thrombosis than jugular or femoral-vein catheterization. However, subclavian-vein placement was also associated with a higher risk of pneumothorax.

Lead researcher Jean-Jacques Parienti, M.D., Ph.D., from the department of biostatistics and clinical research at Cote de Nacre University Hospital in Caen France, told HealthDay that "the subclavian route is the safest for the patient, provided that everything is done to reduce the risk of mechanical complications during insertion."

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