Supraclavicular subclavian venous catheterization through the insertion point medial to the middle of clavicle in infants

Objective To evaluate the effectiveness and safety of percutaneous subclavian venous catheterization through the point of insertion medial to the middle of clavicle in infants.Methods One hundred and fifty infants(88 male,62 female)aged 1-12 months scheduled for major operation were enrolled in this study. Subclavian venous catheterization was performed via supraclavicular approach.The needle was inserted at a point midway between the middle of clavicle and the inner third of clavicle(group Ⅰ,n=50)or at the point where the posterior border of sterno-cleidomastoid muscle(SCM)meets the upper border of clavicle(Yoffa method group Ⅱ, n=50)or at the posterior border of SCM,0.5-1.0 cm above the upper border of clavicle(modified James method,group Ⅲ,n=50).The overall success rate,the success rate at first attempt,the failure rate,the depth of insertion and complications were recorded.Results The 3 groups were comparable with respect to sex ratio,age and body weight.There were no significant differences in overall success rate and failure rate among the 3 groups. The success rate at first attempt in group Ⅰ(86%)was significantly higher than that in group Ⅱ(74%)and group Ⅲ(80%)(P＜0.05).The depth of insertion was significantly greater in group Ⅰ[(2.21+0.28)cm]than in group Ⅱ[(1.79±0.33)cm]and group Ⅲ[(1.84±0.38)cm].No pneumothorax and in advertent arterial puncture and nerve injury occurred in the 3 groups.Conclusion Supraclaricular subclavian venous catheterization through the insertion point medial to the middle of clavicle is better than the conventional methods(Yoffa,James) in terms of success rate at first attempt in infants.