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Previous Volume 348:1123-1133 March 20, 2003 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In the United States, physicians insert more than 5 million central venous catheters every year.¹ Central venous catheters allow measurement of hemodynamic variables that cannot be measured accurately by noninvasive means and allow delivery of medications and nutritional support that cannot be given safely through peripheral venous catheters. Unfortunately, the use of central venous catheters is associated with adverse events that are both hazardous to patients and expensive to treat.^2,3,4 More than 15 percent of patients who receive these catheters have complications.^5,6,7 Mechanical complications are reported to occur in 5 to 19 percent of patients,^5,6,8 infectious complications in 5 to . . . [Full Text of this Article]

Types of Catheters

Antimicrobial-Impregnated Catheters

Single-Lumen and Multilumen Catheters

Insertion Sites

Characteristics of Patients

Mechanical Complications

Infectious Complications

Thrombotic Complications

Insertion Technique

Preparation

Experience with Catheterization

Ultrasound Guidance

Recognition of Arterial Puncture and Prevention of Air Embolism

Prophylactic Antibiotics

Maintenance of the Insertion Site

Ointments, Subcutaneous Cuffs, and Dressings

Hubs and Needleless Access Devices

Catheter Maintenance

Suspected Catheter-Related Bloodstream Infection

Source Information

From the Division of Pulmonary and Critical Care Medicine (D.C.M., M.K.G.), the Department of Health Research and Policy (M.K.G.), and the Center for Primary Care and Outcomes Research (M.K.G.), Stanford University School of Medicine, Stanford, Calif.; and the Health Services Research and Development Service and Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (M.K.G.).

Address reprint requests to Dr. Gould at the Pulmonary and Critical Care Section (111P), Veterans Affairs Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA 94304.

Related Letters:

Preventing Complications of Central Venous Catheterization
Berlin D. A., Perrin L. S., Soltes G. D., Barth M. H., Roehm J. O., Ouriel K., Dewachter P., Mouton-Faivre C., Mertes P.-M., Beer F. A., Towers M. J., Gould M. K., McGee D. C.
Extract | Full Text | PDF  
N Engl J Med 2003; 348:2684-2686, Jun 26, 2003. Correspondence

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