[Puncture catheterization of central veins--experiences from a primary care clinic]

We introduced in the years 1984-1989 317 central venous catheters. Our results and conclusions for using those catheters in smaller hospitals are described.

4 physicians inserted under standardized conditions 317 central venous catheters in the intensive care unit using the transmuscular way for puncturing the V. jugularis interna and the infraclavicular way for puncturing the V. subclavia.

Puncturing the V. basilica complications were not registered. By the V. subclavia route a Pneumothorax rate of 1.7% and an arterial puncture rate of 4.1% were found compared with a 4% arterial puncture rate using the V. jugularis interna. We couldn't find the V. subclavia in 3.4% and the V. jugularis interna in 8%. The complication rate decreased with increasing experience of the physicians. The positions of the catheters in the venous system were not appropriate in 46.9% of the cases after puncture of the V. basilica and in 1.3% after puncture of V. subclavia. Wrong catheter positions were not found after puncturing the V. jugularis interna. Complications as thrombophlebitis were observed in 6.5% after puncturing the V. basilica and 1.1% of the cases after V. subclavia puncture.

Central venous catheters can be safely used also in smaller hospitals if applied by a standardized method. A limited team of physicians can get enough experiences also in a slight number of patients, so that complication rates as low as in international statistics were found.