FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

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.

	Full Text PDF PDA Full Text Supplementary Material Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

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

This article has been cited by other articles:

• ASUDANI, D., WRETZEL, S., PATEL, R., STAYMAN, A. (2008). The Clinical Picture: A judgment call. Cleveland Clinic Journal of Medicine 75: 690-695 [Full Text]  
• Nemec, K., Kopelent-Frank, H., Greif, R. (2008). Standardization of infusion solutions to reduce the risk of incompatibility. Am J Health Syst Pharm 65: 1648-1654 [Abstract] [Full Text]  
• Berns, J. S., O'Neill, W. C. (2008). Performance of Procedures by Nephrologists and Nephrology Fellows at U.S. Nephrology Training Programs. CJASN 3: 941-947 [Abstract] [Full Text]  
• Parienti, J.-J., Thirion, M., Megarbane, B., Souweine, B., Ouchikhe, A., Polito, A., Forel, J.-M., Marque, S., Misset, B., Airapetian, N., Daurel, C., Mira, J.-P., Ramakers, M., du Cheyron, D., Le Coutour, X., Daubin, C., Charbonneau, P., for Members of the Cathedia Study Group, (2008). Femoral vs Jugular Venous Catheterization and Risk of Nosocomial Events in Adults Requiring Acute Renal Replacement Therapy: A Randomized Controlled Trial. JAMA 299: 2413-2422 [Abstract] [Full Text]  
• Lessnau, K.-D. (2008). From Delphi to Knowledge and Comfort: The Devil Is in the Details. Chest 133: 1060-1062 [Full Text]  
• Boersma, R. S., Jie, K.-S. G., Verbon, A., van Pampus, E. C. M., Schouten, H. C. (2008). Thrombotic and infectious complications of central venous catheters in patients with hematological malignancies. Ann Oncol 19: 433-442 [Abstract] [Full Text]  
• Bawa, A. S., Jain, V., Gutierrez, G. (2007). LOCAL PULMONARY HEMORRHAGE AS A COMPLICATION OF SUBCLAVIAN VEIN CATHETERIZATION. Chest 132: 695a-696 [Abstract]  
• Bakshi, K. D., Vaidyanathan, B., Sundaram, K. R., Roth, S. J., Shivaprakasha, K., Rao, S. G., Nair, S. G., Chengode, S., Kumar, R. K. (2007). Determinants of early outcome after neonatal cardiac surgery in a developing country. J. Thorac. Cardiovasc. Surg. 134: 765-771 [Abstract] [Full Text]  
• Reade, M. C., Newton, J. D., Sprigings, D. C., Newsome, L. T., Antonio, B. L., Royster, R. L., Adhya, S., Laha, S. K., Graham, A. S., Tegtmeyer, K., Braner, D. (2007). Central venous catheterization.. NEJM 357: 943-944 [Full Text]  
• Patel, S., O'Neill, F. (2007). 44445 - REMOVAL OF CENTRAL VENOUS CATHETERS DUE TO SUSPECTED CATHETER-RELATED INFECTION. Canadian J. Anesthesia 54: 44445-44445 [Abstract] [Full Text]  
• Feller-Kopman, D. (2007). Ultrasound-Guided Internal Jugular Access: A Proposed Standardized Approach and Implications for Training and Practice. Chest 132: 302-309 [Abstract] [Full Text]  
• Graham, A. S., Ozment, C., Tegtmeyer, K., Lai, S., Braner, D. A.V. (2007). Central Venous Catheterization. NEJM 356: e21-e21  
• Eisen, L. A., Minami, T., Berger, J. S., Sekiguchi, H., Mayo, P. H., Narasimhan, M. (2007). Gender disparity in failure rate for arterial catheter attempts.. J Intensive Care Med 22: 166-172 [Abstract]  
• Suzuki, S., Sanui, M. (2007). A case of paradoxical cerebral thromboembolism after removal of a central venous catheter. Canadian J. Anesthesia 54: 326-327 [Full Text]  
• Dohgomori, H., Shiba, M., Okamoto, K. (2007). Application of normal saline to ultrasonography as an alternative to gel for internal jugular venous cannulation. Canadian J. Anesthesia 54: 246-246 [Full Text]  
• e Albuquerque, M. P. (2007). A Modified Internal Jugular Vein Access for Long-Term Catheter Placement in Cancer Patients. Ann. Surg. Oncol. 14: 937-941 [Abstract] [Full Text]  
• Dhanani, J., Senthuran, S., Olivotto, R., Boots, R. J., Lipman, J. (2007). The entrapped central venous catheter. Br J Anaesth 98: 89-92 [Abstract] [Full Text]  
• Gebhard, R. E., Szmuk, P., Pivalizza, E. G., Melnikov, V., Vogt, C., Warters, R. D. (2007). The Accuracy of Electrocardiogram-Controlled Central Line Placement. Anesth. Analg. 104: 65-70 [Abstract] [Full Text]  
• de Graaff, J. C., Bras, L. J., Vos, J. A. (2006). Early transection of a central venous catheter in a sedated ICU patient. Br J Anaesth 97: 832-834 [Abstract] [Full Text]  
• Whymark, C., Moores, A., MacLeod, A. D. (2006). A Scottish National Prospective Study of airway management skills in new-start SHOs. Br J Anaesth 97: 473-475 [Abstract] [Full Text]  
• Torok-Both, C. J., Jacka, M. J., Brindley, P. G. (2006). Best evidence in critical care medicine: Central venous catheterization: the impact of insertion site.. Canadian J. Anesthesia 53: 524-525 [Full Text]  
• Bailey, P. L., Whitaker, E. E., Palmer, L. S., Glance, L. G. (2006). The accuracy of the central landmark used for central venous catheterization of the internal jugular vein.. Anesth. Analg. 102: 1327-1332 [Abstract] [Full Text]  
• Eisen, L. A., Narasimhan, M., Berger, J. S., Mayo, P. H., Rosen, M. J., Schneider, R. F. (2006). Mechanical complications of central venous catheters.. J Intensive Care Med 21: 40-46 [Abstract]  
• Abdelkefi, A., Torjman, L., Ladeb, S., Ben Othman, T., Achour, W., Lakhal, A., Hsairi, M., Kammoun, L., Ben Hassen, A., Abdeladhim, A. B. (2005). Randomized Trial of Prevention of Catheter-Related Bloodstream Infection by Continuous Infusion of Low-Dose Unfractionated Heparin in Patients With Hematologic and Oncologic Disease. JCO 23: 7864-7870 [Abstract] [Full Text]  
• Vahl, T. P., Ulrich-Lai, Y. M., Ostrander, M. M., Dolgas, C. M., Elfers, E. E., Seeley, R. J., D'Alessio, D. A., Herman, J. P. (2005). Comparative analysis of ACTH and corticosterone sampling methods in rats. Am. J. Physiol. Endocrinol. Metab. 289: E823-E828 [Abstract] [Full Text]  
• Beaulieu, Y., Marik, P. E. (2005). Bedside Ultrasonography in the ICU: Part 2. Chest 128: 1766-1781 [Abstract] [Full Text]  
• Weijmer, M. C., van den Dorpel, M. A., Van de Ven, P. J.G., ter Wee, P. M., van Geelen, J. A.C.A., Groeneveld, J. O., van Jaarsveld, B. C., Koopmans, M. G., le Poole, C. Y., Schrander-Van der Meer, A. M., Siegert, C. E.H., Stas, K. J.F., for the CITRATE Study Group, (2005). Randomized, Clinical Trial Comparison of Trisodium Citrate 30% and Heparin as Catheter-Locking Solution in Hemodialysis Patients. J. Am. Soc. Nephrol. 16: 2769-2777 [Abstract] [Full Text]  
• Cook, R. J., Ashton, R. W., Aughenbaugh, G. L., Ryu, J. H. (2005). Septic Pulmonary Embolism: Presenting Features and Clinical Course of 14 Patients. Chest 128: 162-166 [Abstract] [Full Text]  
• McLean, T. W., Fisher, C. J., Snively, B. M., Chauvenet, A. R. (2005). Central Venous Lines in Children With Lesser Risk Acute Lymphoblastic Leukemia: Optimal Type and Timing of Placement. JCO 23: 3024-3029 [Abstract] [Full Text]  
• von Goedecke, A., Keller, C., Moriggl, B., Wenzel, V., Bale, R., Deibl, M., Moser, P., Lirk, P. (2005). An Anatomic Landmark to Simplify Subclavian Vein Cannulation: The "Deltoid Tuberosity". Anesth. Analg. 100: 623-628 [Abstract] [Full Text]  
• Lessnau, K.-D. (2005). Is Chest Radiography Necessary After Uncomplicated Insertion of a Triple-Lumen Catheter in the Right Internal Jugular Vein, Using the Anterior Approach?. Chest 127: 220-223 [Abstract] [Full Text]  
• Jackson, W L Jr, Gallagher, C, Myhand, R C, Waselenko, J K (2005). Medical management of patients with multiple organ dysfunction arising from acute radiation syndrome. Br. J. Radiol. Supplement_27: 161-168 [Abstract] [Full Text]  
• Yucel, N., Lefering, R., Maegele, M., Max, M., Rossaint, R., Koch, A., Schwarz, R., Korenkov, M., Beuth, J., Bach, A., Schierholz, J., Pulverer, G., Neugebauer, E. A. M. (2004). Reduced colonization and infection with miconazole-rifampicin modified central venous catheters: a randomized controlled clinical trial. J Antimicrob Chemother 54: 1109-1115 [Abstract] [Full Text]  
• Hunter, T. B., Taljanovic, M. S., Tsau, P. H., Berger, W. G., Standen, J. R. (2004). Medical Devices of the Chest. RadioGraphics 24: 1725-1746 [Abstract] [Full Text]  
• Geggel, R. L. (2004). Conditions Leading to Pediatric Cardiology Consultation in a Tertiary Academic Hospital. Pediatrics 114: e409-e417 [Abstract] [Full Text]  
• Sader, H. S., Fedler, K. A., Rennie, R. P., Stevens, S., Jones, R. N. (2004). Omiganan Pentahydrochloride (MBI 226), a Topical 12-Amino-Acid Cationic Peptide: Spectrum of Antimicrobial Activity and Measurements of Bactericidal Activity. Antimicrob. Agents Chemother. 48: 3112-3118 [Abstract] [Full Text]  
• Zurcher, M., Tramer, M. R., Walder, B. (2004). Colonization and Bloodstream Infection with Single- Versus Multi-Lumen Central Venous Catheters: A Quantitative Systematic Review. Anesth. Analg. 99: 177-182 [Abstract] [Full Text]  
• Waitt, C, Waitt, P, Pirmohamed, M (2004). Intravenous therapy. Postgrad. Med. J. 80: 1-6 [Abstract] [Full Text]  
• Verso, M., Agnelli, G. (2003). Venous Thromboembolism Associated With Long-Term Use of Central Venous Catheters in Cancer Patients. JCO 21: 3665-3675 [Abstract] [Full Text]  
• Krayem, H. K., Bowles, A., Hanbali, A. (2003). Mediastinal Hematoma With SVC Syndrome From A Central Venous Catheter Insertion: A Case Report. Chest 124: 314S-314 [Abstract] [Full Text]  
• Fritz, H. G., Kuehn, D., Haberland, N., Kalff, R. (2003). Anesthesia Management for Spine Surgery Using Spinal Navigation in Combination with Computed Tomography. Anesth. Analg. 97: 863-866 [Abstract] [Full Text]  
• 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. (2003). Preventing Complications of Central Venous Catheterization. NEJM 348: 2684-2686 [Full Text]