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June 18, 1982

Subclavian Vein Catheterization During Cardiopulmonary Resuscitation: A Prospective Comparison of the Supraclavicular and Infraclavicular Percutaneous Approaches

JAMA. 1982;247(23):3227-3230. doi:10.1001/jama.1982.03320480043024

Percutaneous access to the central venous circulation is indicated in the management of some cardiopulmonary arrests. We prospectively studied 89 attempted subclavian vein catheterizations in a total of 76 patients. There were 44 supraclavicular (SC) and 45 infraclavicular (IC) approaches. We found that the percutaneous SC route provides a better technique than the IC approach: it is associated with fewer failures, less difficulty in the mechanics of line insertion, a higher incidence of proper catheter tip location, and much less interference with cardiopulmonary resuscitation in normal, obese, and cachectic patient subgroups. Successful performance occurred despite a documented lack of physician experience with the SC technique, indicating that it should be taught during advanced cardiac life support training courses.

(JAMA 1982;247:3227-3230)