New syringe to prevent mechanical complications of central venous catheter placement.

Prompted by the continued frequency of mechanical complications associated with central venous catheter placement, a more effective and stable and safer catheter placement device has been proposed. Fifteen critically ill surgical patients who required central venous access for total parenteral nutrition (TPN) and fluid management had a central venous catheter placed using the new syringe technique. Despite an equipment-use learning curve, there was no equipment failure. In 14 patients, catheter placement was successful. In one dehydrated patient, repeated attempts at percutaneous infraclavicular subclavian access were not successful, but internal jugular vein access was gained. There were no mechanical or infectious complications in the 15 patients. The new syringe provides a stable platform, reducing the fumbling usual when disconnecting the needle from the syringe and thereby avoiding the potential complications of dislodgment or hub contamination of the introducer needle and air embolism.