CARING FOR THE CRITICALLY ILL PATIENT Complications of Femoral and Subclavian Venous Catheterization in Critically Ill Patients A Randomized Controlled Trial

CENTRAL VENOUS CATHETERization is often necessary to treat critically ill patients hospitalized in intensive care units (ICUs). However, this procedure can lead to serious and sometimes life-threatening complications, whether mechanical, infectious, or thrombotic. The choice of insertion site can influence the incidence and type of such complications. Major femoral or retroperitoneal hematoma is the most frequent major mechanical complication of femoral venous catheterization, occurring in up to 1.3% of cases, whereas pneumothorax is the most frequent major complication of subclavian venous catheterization, occurring in 1.5% to 2.3% of cases. Reported rates of catheterrelated thrombosis range from 6.6% to 25% with femoral catheterization and from 10% to 50% with subclavian catheterization. These differences may be related to use of various diagnostic ap-