Alternative technique for subclavian vein cannulation

Subclavian vein catheterism, a commonly used methodology in ICU, is not devoid of complications, even some serious ones (Pneumothorax 0.5%).

The authors propose an alternative technique based on the use of an introducer needle bent on its own axis to form an arch with its concavity turned towards the Quincke point. On searching the blood vessel, once the subclavian plane has been reached, the needle advancement towards the jugular fosse happens by following the needle curvature. In this way the operator can keep the needle on a plane parallel to the cutaneous one, and all the complications due to involuntary exceeding of the costal plane are avoided. The response of this new technique in 110 patients (study group) is compared through a retrospective study, to 100 patients with whom the standard technique has been used (control group).

The study group has presented a significant reduction both of total complications (p<0.05) and of total failures (p< 0.01).

Such results, although pertinent to a still limited study, testify to an improvement in terms of security and efficacy, with the new alternative technique without an increase in costs.