Nazir Atif, Niazi Khurram, Zaidi Syed Muhammad Jawad, Ali Muhammad, Maqsood Saeed, Malik Jahanzeb, Kaneez Mehwish, Mehmoodi Amin
Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, PAK.
Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Cureus. 2022 Apr 3;14(4):e23781. doi: 10.7759/cureus.23781. eCollection 2022 Apr.
Central venous catheterization plays a key role in patients that require immediate resuscitation, long-term fluid management, and invasive monitoring. The supraclavicular (SC) and infraclavicular (IC) approaches are utilized for central venous catheterization and both have their benefits and limitations. In this systematic review, we aim to explore the success rate and various complications of the SC technique. A literature review was conducted on the PubMed, EMBASE, Scopus, CINAHL, and Cochrane databases. All relevant original articles that evaluated success rates and complications of SC access were retrieved and included for qualitative synthesis. After screening 1040 articles, 28 studies were included for further analysis. The overall success rate of SC access ranged between 79% and 100%. The overall complication rate in SC access ranged between 0% and 24.24% (Mean: 4.27%). The most prevalent complication was arterial puncture (1.39%) followed by catheter malposition (0.42%). The SC approach can be used as an alternative to the IC technique because of its low access time and high success rate. The SC approach should be more commonly used in day-to-day central venous cannulation. Further studies on the role of ultrasound guidance are warranted for the SC approach.
中心静脉置管在需要立即复苏、长期液体管理和有创监测的患者中起着关键作用。锁骨上（SC）和锁骨下（IC）途径用于中心静脉置管，两者都有其优点和局限性。在本系统评价中，我们旨在探讨SC技术的成功率和各种并发症。对PubMed、EMBASE、Scopus、CINAHL和Cochrane数据库进行了文献综述。检索并纳入所有评估SC入路成功率和并发症的相关原始文章进行定性综合分析。在筛选了1040篇文章后，纳入28项研究进行进一步分析。SC入路的总体成功率在79%至100%之间。SC入路的总体并发症发生率在0%至24.24%之间（平均：4.27%）。最常见的并发症是动脉穿刺（1.39%），其次是导管位置不当（0.42%）。由于SC入路时间短且成功率高，可作为IC技术的替代方法。SC入路应更常用于日常中心静脉插管。有必要对超声引导在SC入路中的作用进行进一步研究。
