A study to evaluate the influence of shoulder position on central venous catheter tip location during infraclavicular subclavian approach

Abstract

Background and Objective: Subclavian vein (SV) catheterization via infraclavicular approach is routinely done for multiple uses in operating rooms as well as in intensive care units in selected patients. The aim of this study was to evaluate the influence of shoulder position on central venous catheter (CVC) tip location during infraclavicular subclavian approach.

Methodology: A prospective observational study was conducted on 60 patients and included American Society of Anesthesiologist (ASA) physical status 1 and 2 patients in whom CVC was planned. Catheters were introduced either in neutral shoulder position or the shoulder was lowered during venipuncture and guide wire insertion. A post-operative chest x-ray was done to note any complications and catheter tip malposition.

Results: Demographic data was comparable between the two groups with respect to age, gender and weight. (P > 0.05). In one case in Group A, and two cases in Group B there was failure to puncture the vein but this was statistically insignificant (P = 0.554). Failure to thread the guidewire was seen in one case in each group with no statistical significance (P > 0.05) Statistical difference was noted in successful placement of CVC tip between the two shoulder position (P = 0.025).