Mechanical complications after central venous catheterisation in the ultrasound-guided era : a prospective multicentre cohort study
(2022) In British Journal of Anaesthesia 129(6). p.843-850- Abstract
BACKGROUND: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.
METHODS: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to... (More)
BACKGROUND: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.
METHODS: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications.
RESULTS: In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m
-2 (odds ratio 2.69 [95% CI: 1.17-5.62]), male operator gender (3.33 [1.60-7.38]), limited operator experience (3.11 [1.64-5.77]), and increasing number of skin punctures (2.18 [1.59-2.88]) were associated with major mechanical complication. Subclavian vein catheterisation was associated with pneumothorax (5.91 [2.13-17.26]).
CONCLUSIONS: The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates.
CLINICAL TRIAL REGISTRATION: NCT03782324.
(Less)
- author
- Adrian, Maria LU ; Borgquist, Ola LU ; Kröger, Tina ; Linné, Erik LU ; Bentzer, Peter LU ; Spångfors, Martin LU ; Åkeson, Jonas LU ; Holmström, Anders LU ; Linnér, Rikard LU and Kander, Thomas LU
- organization
- publishing date
- 2022-10-21
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Anaesthesia
- volume
- 129
- issue
- 6
- pages
- 843 - 850
- publisher
- Elsevier
- external identifiers
-
- pmid:36280461
- scopus:85140636024
- ISSN
- 1471-6771
- DOI
- 10.1016/j.bja.2022.08.036
- language
- English
- LU publication?
- yes
- additional info
- Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
- id
- 20cd2748-87a9-44c1-b159-69ee93e7f71d
- date added to LUP
- 2022-10-27 22:39:54
- date last changed
- 2024-04-17 20:10:28
@article{20cd2748-87a9-44c1-b159-69ee93e7f71d, abstract = {{<p>BACKGROUND: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.</p><p>METHODS: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion. Every insertion was monitored for complete documentation and occurrence of mechanical complications within 24 h after catheterisation. Multivariable logistic regression analyses were used to determine associations between predefined variables and mechanical complications.</p><p>RESULTS: In total, 12 667 catheter insertions in 8586 patients were included. The incidence (95% confidence interval [CI]) of mechanical complications was 7.7% (7.3-8.2%), of which 0.4% (0.3-0.5%) were major complications. The multivariable analyses showed that patient BMI <20 kg m<br> -2 (odds ratio 2.69 [95% CI: 1.17-5.62]), male operator gender (3.33 [1.60-7.38]), limited operator experience (3.11 [1.64-5.77]), and increasing number of skin punctures (2.18 [1.59-2.88]) were associated with major mechanical complication. Subclavian vein catheterisation was associated with pneumothorax (5.91 [2.13-17.26]).<br> </p><p>CONCLUSIONS: The incidence of major mechanical complications is low in hospitals where real-time ultrasound guidance is the standard of care for central venous access. Several variables independently associated with mechanical complications can be used for risk stratification before catheterisation procedures, which might further reduce complication rates.</p><p>CLINICAL TRIAL REGISTRATION: NCT03782324.</p>}}, author = {{Adrian, Maria and Borgquist, Ola and Kröger, Tina and Linné, Erik and Bentzer, Peter and Spångfors, Martin and Åkeson, Jonas and Holmström, Anders and Linnér, Rikard and Kander, Thomas}}, issn = {{1471-6771}}, language = {{eng}}, month = {{10}}, number = {{6}}, pages = {{843--850}}, publisher = {{Elsevier}}, series = {{British Journal of Anaesthesia}}, title = {{Mechanical complications after central venous catheterisation in the ultrasound-guided era : a prospective multicentre cohort study}}, url = {{http://dx.doi.org/10.1016/j.bja.2022.08.036}}, doi = {{10.1016/j.bja.2022.08.036}}, volume = {{129}}, year = {{2022}}, }