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Mechanical complications during central venous cannulations in pediatric patients
Intensive Care Medicine, 06/22/09

Rey C et al. - EMC of CVC were common in a teaching university hospital, but severe complications were very uncommon. Resident failure to perform CVC, high venous access, and number of attempts were independent risk factors for EMC of CVC.

Exclusive Author Commentary
Corsino Rey, 06/23/09

The strengths of the study were that it is a paediatric prospective cohort done in a 10-yr period, which allowed findings defining safety issues surrounding cannulation to be representative of a long period. Morover, it is the biggest study focusing on risk factors of EMC in critically ill children. The most commons EMC were arterial puncture (n=60; 7.2%), catheter malposition (n=39; 4.7%), arrhythmias (n=19; 2.3%) and hematoma (n=12; 1.4%). Resident failure to perform CVC (OR 2.53; CI 95% 1.53-4.16), high venous access (subclavian or jugular) (OR 1.91; CI 95% 1.26-2.88) and number of attempts (OR 1.10; CI 95% 1.03-1.17) were independently associated with EMC

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