Patient Positioning for Subclavian Vein Catheterization

The subclavian vein is a commonly used venous access route. Percutaneous cannulation is associated with complications and malpositioning of the catheter. We studied the potential effect of various body positions on subclavian vein catheterization using gross anatomic dissection and magnetic resonance imaging. Findings show that traditional recommendations for patient positioning with the shoulders retracted and the head turned away can act to distort the subclavian vein anatomy and make successful cannulation more difficult. Positioning the patient flat with the head and shoulders in a neutral position is suggested.