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Comparison of central venous catheterization sites in infants

S H Han1, S D Kim, C S Kim

  • 1Department of Anaesthesiology, Seoul National University Bundang Hospital, Seoul, Korea.

The Journal of International Medical Research
|December 14, 2004
PubMed

Insights

Internal jugular vein catheterization offers superior success rates and fewer complications compared to subclavian routes in infants. This finding suggests the internal jugular vein, particularly the right side, is the preferred site for central venous catheterization in neonates.

Area of Science:

  • Pediatric critical care medicine
  • Vascular access procedures
  • Infant health outcomes

Background:

  • Central venous catheterization is a critical procedure in infant care.
  • Choosing the optimal insertion site impacts procedural success and patient safety.
  • Subclavian and internal jugular veins are common access points, each with potential risks.

Purpose of the Study:

  • To compare the efficacy and safety of central venous catheterization at different anatomical sites in infants.
  • To determine the preferred venous access site for pediatric central line placement.
  • To evaluate success rates and complication profiles across four specific catheterization sites.

Main Methods:

  • A randomized controlled trial involving 272 infants undergoing central venous catheterization.
  • Infants were allocated to four groups: right subclavian (G-RSCV), right internal jugular (G-RIJV), left subclavian (G-LSCV), and left internal jugular vein (G-LIJV).
  • Data collected included first-attempt success rates and incidence of specific complications such as arterial puncture, guidewire failure, and malpositioning.

Main Results:

  • Overall first-attempt success rate was 77.2%.
  • The highest successful catheter placement rate was observed in the left subclavian vein group (55.9%).
  • Complication rates (arterial puncture, guidewire failure, malpositioning) were significantly higher with subclavian vein catheterization (SCV) compared to internal jugular vein (IJV) catheterization (e.g., 10.1% vs. 2.1% for arterial puncture).

Conclusions:

  • Internal jugular vein (IJV) catheterization, especially via the right internal jugular vein (RIJV), is associated with significantly lower complication rates.
  • The IJV appears to be a safer and more effective site for central venous catheterization in infants compared to the subclavian vein (SCV).
  • RIJV should be considered the primary choice for central venous catheterization in the pediatric population to minimize procedural risks.

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