Key result
Supraclavicular subclavian catheterization during CPR is linked to fewer failures and less interference versus infraclavicular.
Why the study?
Does the supraclavicular approach improve procedural success and reduce interference compared to the infraclavicular approach for subclavian vein catheterization during cardiopulmonary resuscitation?
Observational (n=76)
Does the supraclavicular approach improve procedural success and reduce interference compared to the infraclavicular approach for subclavian vein catheterization during cardiopulmonary resuscitation?
The supraclavicular approach for subclavian vein catheterization during CPR is superior to the infraclavicular approach, with fewer failures and less interference with resuscitation.
May support supraclavicular subclavian access during CPR to reduce failures and interference; hypothesis-generating and requires randomized confirmation before practice change.
Percutaneous access to the central venous circulation is indicated in the management of some cardiopulmonary arrests. We prospectively studied 89 attempted subclavian vein catheterizations in a total of 76 patients. There were 44 supraclavicular (SC) and 45 infraclavicular (IC) approaches. We found that the percutaneous SC route provides a better technique than the IC approach: it is associated with fewer failures, less difficulty in the mechanics of line insertion, a higher incidence of proper catheter tip location, and much less interference with cardiopulmonary resuscitation in normal, obese, and cachectic patient subgroups. Successful performance occurred despite a documented lack of physician experience with the SC technique, indicating that it should be taught during advanced cardiac life support training courses. (JAMA1982;247:3227-3230)
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Steven C. Dronen (1982) conducted an observational in Cardiopulmonary arrest (n=76). Supraclavicular approach vs. Infraclavicular approach was evaluated on Failures, difficulty in mechanics of line insertion, proper catheter tip location, and interference with CPR. The percutaneous supraclavicular approach for subclavian vein catheterization during CPR was associated with fewer failures and less interference than the infraclavicular approach.
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