Percutaneously inserted catheters are the most commonly used central catheters. Several risk factors have been identified, however, that are associated with bloodstream infections. These include the site of placement.
Mermel et al. were able to demonstrate that the great majority of infections develop at the insertion site. Other risk factors were use of the jugular insertion site over the subclavian site. [1] In addition, for use of total parenteral nutrition, McCarthy demonstrated a similar effect [2].
Whenever possible, and not contraindicated, the subclavian line site should be preferred over the jugular site.
References:
-
Mermel LA, McCormick RD, Springman SR, Maki DG. The pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters: A prospective study utilizing molecular subtyping. Am J Med. Sep 16 1991;91(3B):197S-205S.
-
McCarthy MC, Shives JK, Robison RJ, Broadie TA. Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. J Parenter Enteral Nutr. 1987 May-Jun;11(3):259-62.
