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Previous Volume 357:e26 December 13, 2007 Number 24 Next

	Since this article has no abstract, below are the first 100 words from the narration of this Video in Clinical Medicine and its chapter headings.

 

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View Video Evidence suggests that the risk of major central venous line complications, particularly line-related bloodstream infections, is lower when the subclavian approach is used. This video will identify the landmarks and procedure for placement of a subclavian central line. Specific contraindications for the placement of a central venous line in the subclavian vein include infection of the area overlying the target vein and thrombosis of the target vein and fracture or suspected fracture of the clavicle or proximal ribs. Coagulopathy, while not an absolute contraindication, should be of greater concern with the subclavian approach because of the difficulty in applying . . . . Chapters: Overview Preparation Placing the Line Troubleshooting

 
References

1. Implement the central line bundle. Cambridge, MA: Institute for Healthcare Improvement. (Accessed November 16, 2007, at http://www.ihi.org/ihi/topics/criticalcare/intensivecare/changes/implementthecentrallinebundle.htm.) 
2. Fortune JB, Feustel P. Effect of patient position on size and location of the subclavian vein for percutaneous puncture. Arch Surg 2003;138:996-1000. [Free Full Text]
3. Orihashi K, Imai K, Sato K, Hamamoto M, Okada K, Sueda T. Extrathoracic subclavian venipuncture under ultrasound guidance. Circ J 2005;69:1111-1115. [CrossRef][ISI][Medline]
4. Pirotte T, Veyckemans F. Ultrasound-guided subclavian vein cannulation in infants and children: a novel approach. Br J Anaesth 2007;98:509-514. [Free Full Text]

Related Letters:

Central Venous Catheterization — Subclavian Vein
Harris S., Naina H. V.K., Evans F. C., Graham C. A., Schummer W., Fröber R., Schummer C., Braner D. A.V., Tegtmeyer K.
Extract | Full Text | PDF  
N Engl J Med 2008; 358:1758-1760, Apr 17, 2008. Correspondence

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