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Percutaneous central venous access for resuscitation in trauma
T M Scalea1, R Sinert, A O Duncan
1Department of Emergency Medicine and Surgery, SUNY Health Science Center at Brooklyn, USA.
Summary
Percutaneous central venous access is a safe and effective method for trauma resuscitation, with high success rates and low complication rates regardless of patient hemodynamics or insertion site.
Area of Science:
- Emergency Medicine
- Critical Care
- Vascular Access
Background:
- Trauma resuscitation requires rapid and reliable intravenous access.
- Peripheral venous access may be difficult or inadequate in critically injured patients.
- Central venous access offers a potential solution for challenging resuscitation scenarios.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous central venous access in trauma resuscitation.
- To determine if patient hemodynamic status or insertion site influences the success or ease of central line placement.
Main Methods:
- A protocol guided the use of central venous access in major trauma patients after initial peripheral access attempts.
- Specific insertion sites (subclavian, internal jugular, femoral) were chosen based on injury patterns.
- Data on success rates, complication rates, and time to placement were collected.
Main Results:
- Central venous access was successful in 99% of attempts (144/147 sites).
- A single major complication occurred (0.7% rate).
- Neither hemodynamic status nor insertion site affected placement time, number of attempts, or complication rates.
Conclusions:
- Percutaneous central venous access is safe and reliable for trauma resuscitation in experienced centers.
- The technique's utility in trauma resuscitation warrants consideration for broader application.