Subclavian site should be preferred for central venous access
Commentary on: Parienti JJ, Mongardon N, Mégarbane B, et al.., 3SITES Study Group. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med 2015;373:1220–9. Implications for practice and research Subclavian site should be preferred for central venous access (CVA) with a low risk of pneumothorax. Excluding patients before randomisation represents a selection bias. Post hoc sensitivity analysis may reduce the bias without fully balancing it. An adjudication committee, unaware of study-group assignments, may compensate for the absence of feasible blindness. Context Infection, thrombosis and mechanical adverse events are complications of central venous catheterisation. Catheter-related bloodstream infection (CRBI) has a significant impact on morbidity, mortality and health costs.1 Randomised controlled trials (RCT) found that subclavian access was associated with a lower risk of complications compared to femoral access2 but no difference between internal jugular and femoral accesses...
Source: Evidence-Based Nursing - Category: Nursing Authors: Mourvillier, B., Radjou, A., Timsit, J.-F. Tags: Health policy, Nursing issues, Drugs: infectious diseases, Drugs: cardiovascular system, Stroke, Ophthalmology, Venous thromboembolism, Health service research Source Type: research
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