Central venous catheterization: a randomized comparison between external and internal jugular access

Td Correa,Ab Cavalcanti,Aj Pereira,A Capone Neto,Ca Rosa,Mb Ferri,F Campos,Rdh Passos

doi:10.1186/cc7864

Abstract

Central venous catheterization is a routine procedure in intensive care, and internal jugular access (IJA) is often used due to its high success rates. However, complications can happen in up to 4.2% of internal jugular punctures and it is contraindicated in the presence of coagulopathy. The external jugular access (EJA) is underused, has low complications rates and is successful in up to 90% of cases. So far, there has been no randomized, controlled trial comparing both accesses. The objective of this study was to determine the success and early complication rates of internal and external jugular vein access [1].

Highlights

Many authors have written about the need to treat patients closer to their beds, in order to observe them more as distinct people
We found that CCR2–/– mice subjected to severe sepsis by cecal ligation and puncture (CLP) exhibited reduced neutrophil infiltration in the heart, lung and kidney and an enhanced survival rate when compared with WT mice subjected to severe sepsis
Our findings demonstrated that Toll-like receptors (TLRs) activation induced the CCR2 expression and CCL2 responsiveness in human and murine neutrophils, and this expression profile in neutrophils is involved in the detrimental infiltration of these cells in distant tissues during server sepsis

Summary

Introduction

Many authors have written about the need to treat patients closer to their beds, in order to observe them more as distinct people. Aortic dissection and aneurysm groups were analyzed against each other; and AAD patients were compared with paired matched CABG brackets for morbidity (postoperative complications and ICU and hospital lengths of stay) and 1-month and 6-month mortality. The incidence of VAP is high, varying between 6% and 52%, depending on the studied population, on the type of UTI and on the type of diagnosis technique used; in spite of being an extremely important infection, it is one of the most difficult diagnoses in critically ill patients. The objective of the present study was to assess the effectiveness of a daily MDR to improve compliance with the VAP bundle recommendations and other beneficial prophylactic measures in a high-volume critical care unit. Objective To verify the validity of the ADHERE CART method to stratify the risk of inhospital mortality of patients admitted with ADHF in a high-complexity Brazilian hospital

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