“A Study of Indications and Complications of Central Venous Catheterization in Patients of Intensive Care Unit”

Background: Central venous catheters play a vital role in medical practice enabling clinicians to monitor and support the efforts of the body to stabilize the circulation and provide nutritional supplements. Objectives: This study was conducted to study various indications, sites of insertion and complications of central venous catheterization. Methods: This article reviews our experience with 609 central venous catheters (CVC) inserted in 589 critically ill adult patients of Medical Intensive Care Unit (MICU) or Artificial Kidney Dialysis Unit (AKD) following a standard protocol during study period. Various indications, insertion sites, type, size and material of catheter used, duration and reason of removal of catheter, complications were all documented. Chi square test was used to calculate the statistical significance and a P value of 0.05 or less considered statistically significant. Results: Commonest indication for central venous catheterization (CVC) was hemodynamic monitoring (93.9%) and most common site of insertion was cephalic vein (62.07%). Complications occurred in 165 (27.09%) out of 609 CVC. Excess bleeding (27.8%) was the commonest complication, followed by venous thrombosis (20.6%), catheter related sepsis (CRS) (15.7%) and arterial puncture (13.3%). Conclusions: Platelet count and coagulation profile should be checked before the procedure. Central venous catheterization performed under standard protocol is a very effective and safe route of providing venous access. This procedure should be performed under strict aseptic precautions with minimal percutaneous punctures to decrease complication rates.