Factors Contributing To Unsuccessful Central Line Placement In The Neck And Chest

Abstract

Objective: To date, no prospective studies have analyzed which multivariate factors correlate to a successful placement. We ques-tion whether MAP and obesity are contributors to central line place- ments in the IJ and subclavian veins. Methods: All trauma patients aged 14 to 90 requiring central venous access were considered. Data on obesity, diabetes mellitus, hypotension, ventilator dependency, contractures, inline cervical spine immobilization, placement site, and emergency cases was collected. Pediatrics cases and those in which the form was incorrect or incomplete were excluded. Of the 145 cases, 134 were included in the analysis. Logistic regression was used to analyze the raw data, using IBM SPSS 2014 software. Results: The study population was 134 patients. BMI and MAP did not contribute to line failure (p<0.297, p<0.915), but MAP >60 was correlated with increase success in line placement (p<0.002). Medical residents and surgical residents were more likely to have failures over emergency medicine residents. Conclusion: There are inherent risks which need to be outlined to the patient. Lack of preparation and experience increases the like-lihood of devastating complications. Central venous catheter placement can be done safely and provide much needed access for criti- cally ill patients, with time, guidance, and volume.