Which is the Easiest and Safest Technique for Central venous Access? A Retrospective Survey of more than 5,400 Cases:

摘要: There is an ongoing debate on the technique for central venous catheterization associated with lowest complication rate and highest success rate. In attempt to better define easiest safest approach, we have reviewed our 7-year experience 5479 percutaneous punctures (by Seldinger's technique) insertion of short-term (n=2109), medium/long-term (n=2627) catheters, as well double-lumen, large-bore catheters hemodialysis and/or hemapheresis (n=743). We analyzed incidence most frequent in-sertion-related complications by comparing seven different approaches: jugular vein, low lateral approach; high axial subclavian infraclavicular supraclavicular external vein; femoral vein. The results retrospective study suggest that 'low lateral' approach internal described Jernigan modified according protocol, appears be access, being characterized accidental arte-rial puncture (1.2%) malposition (0.8%), no pneumothorax, extremely repeated attempts (i.e. more than two before successful cannulation) (3.3%). advocate vein first-choice venipuncture in both adults children, long-term cannulation.