Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Mechanical complications after central venous catheterisation in the ultrasound-guided era : a prospective multicentre cohort study

Adrian, Maria LU orcid ; Borgquist, Ola LU ; Kröger, Tina ; Linné, Erik LU orcid ; Bentzer, Peter LU ; Spångfors, Martin LU orcid ; Åkeson, Jonas LU ; Holmström, Anders LU ; Linnér, Rikard LU and Kander, Thomas LU orcid (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)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and
organization
publishing date
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 &lt;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}},
}