Analysis of 13 800 subclavian vein catheterizations.

During the period 1974-1983, 13 857 subclavian or internal jugular vein catheterizations were analysed in the same hospital. The data on the catheterizations have been collected prospectively in the hospital computer. In 93% of the cases, catheterization was subclavian vein cannulation performed through the infraclavicular route. In 15% of the cases the catheter position was not ideal, verified with x-ray; e.g. the catheter tip was turned into the internal jugular vein. Of the catheters 70% were kept in place for less than 7 days, and only 6% for over 2 weeks. More than one catheterization was required in 26% of the cases during the same hospitalization. Recatheterization is an important prophylactic measure for preventing septic complications, if suspicion of infection arises. In 5% of the cases, some complications occurred, but they were mostly minor, such as haematoma at the puncture site. More serious complications were 19 pneumothoraces (0.1%). The results suggest that subclavian vein catheterization is a fairly safe method for large-scale use in a hospital, if only a limited group of physicians perform it. Certain precautions should, however, be taken.