Complications and side effects associated with large-bore catheters in the subclavian and internal jugular veins

Abstract

Since the introduction of large-bore catheters for acute hemodialysis 30 years ago, many problems with handling, material, and contamination of these catheters exist. Nevertheless, catheterization of the inferior and superior vena cava with a large-bore catheter has proved to be suitable as a rapid connection process for hemodialysis, hemofiltration, hemoperfusion, plasmapheresis, plasmaperfusion, among others. In a retrospective study with 2,741 large-bore catheters in 1,716 patients, the frequency of infections, thrombosis, bleeding, and other side effects was investigated. All complications and side effects are presented dependent on vascular access route. In total, the complication rate was 48.9% higher in subclavian puncture than in internal jugular puncture (24.8%). The highest complication rates for both vascular access routes were infections or septicemia; infections were observed in 19.5% of subclavian catheters versus 10% of internal jugular catheters.