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Volume 358:1758-1760 April 17, 2008 Number 16
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Central Venous Catheterization — Subclavian Vein

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by Braner, D. A.V.
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To the Editor: In their video and accompanying article, Braner et al. (Dec. 13 issue)1 omit an important and common complication of subclavian central-venous-catheter placement — misplacement of the catheter tip in the internal jugular vein. This occurs in approximately 5% of patients, with the catheter tip most commonly misplaced in the ipsilateral internal jugular vein.2 Misplaced catheters increase the risk of thrombophlebitis, thrombosis, and inaccurate measurements of central venous pressure. There are a few excellent bedside maneuvers that may reduce the incidence of misplacement of the central venous catheter in the internal jugular vein. The Ambesh maneuver, which involves . . . [Full Text of this Article]



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