comparative study of supraclavicular versus infraclavicular approach for central venous catheterization

ABSTRACT

Supraclavicular approach to subclavian vein catheterization is still being employed less often than traditional infraclavicular approach. The purpose of this study was to compare the two techniques regarding number of attempts, success rate of catheterization and complications associated with the procedure. Surgical Intensive Care Unit [SICU] of Rehman Medical Institute, Peshawar [Pakistan]. 1[st] June 2010 to 30[th] December 2010. We included 144 adult patients of either sex undergoing central venous catheterization for various indications, selected by nonrandom sampling, in the study. They were divided into the supraclavicular and infraclavicular groups [72 in each group]. Right subclavian vein of the patient was chosen in all patients for catheterization. Variables for comparison included number of attempts, success or failure of catheterization and complications associated with the procedure in each group. Statistical analysis was done by applying Chi-square test and Student's Independent Samples T-test. The overall success rate was 95.83% for right supraclavicular and 87.50% for right infraclavicular approach [p>0.05]. The number of successful attempts for supraclavicular and infraclavicular approaches were 1.13 +/- 0.42 and 1.35 +/- 0.69 respectively [P=0.029]. The complication rate was higher in the supraclavicular group, but the difference was not statistically significant. The supraclavicular approach to subclavian vein cannulation was found to be a more successful method for adult central venous catheterization with complications comparable to the more commonly used infraclavicular approach: