作者
Jean-Jacques Parienti, Nicolas Mongardon, Bruno Mégarbane, Jean-Paul Mira, Pierre Kalfon, Antoine Gros, Sophie Marqué, Marie Thuong, Véronique Pottier, Michel Ramakers, Benoît Savary, Amélie Seguin, Xavier Valette, Nicolas Terzi, Bertrand Sauneuf, Vincent Cattoir, Leonard A Mermel, Damien Du Cheyron
发表日期
2015/9/24
期刊
New England Journal of Medicine
卷号
373
期号
13
页码范围
1220-1229
出版商
Massachusetts Medical Society
简介
Background
Three anatomical sites are commonly used to insert central venous catheters, but insertion at each site has the potential for major complications.
Methods
In this multicenter trial, we randomly assigned nontunneled central venous catheterization in patients in the adult intensive care unit (ICU) to the subclavian, jugular, or femoral vein (in a 1:1:1 ratio if all three insertion sites were suitable [three-choice scheme] and in a 1:1 ratio if two sites were suitable [two-choice scheme]). The primary outcome measure was a composite of catheter-related bloodstream infection and symptomatic deep-vein thrombosis.
Results
A total of 3471 catheters were inserted in 3027 patients. In the three-choice comparison, there were 8, 20, and 22 primary outcome events in the subclavian, jugular, and femoral groups, respectively (1.5, 3.6, and 4.6 per 1000 catheter-days; P=0.02). In pairwise comparisons, the risk of the …
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JJ Parienti, N Mongardon, B Mégarbane, JP Mira… - New England Journal of Medicine, 2015