Template:Central line contraindications: Difference between revisions
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==Contraindications== | ==Contraindications== | ||
===Absolute<ref>Graham, A.S., et al. Central Venous Catheterization. N Engl J Med 2007;356:e21</ref>=== | |||
*Infection over the placement site | *Infection over the placement site | ||
*Distortion of landmarks by trauma or congenital anomalies | *Anatomic obstruction (thrombosis of target vein, other anatomic variance) | ||
*Site-specific | |||
**Subclavian - trauma/fracture to ipsilateral clavicle or proximal ribs | |||
===Relative=== | |||
*[[Coagulopathy]] (see below) | |||
*Distortion of landmarks by trauma or congenital anomalies | |||
*Prior vessel injury or procedures | *Prior vessel injury or procedures | ||
*Morbid obesity | *Morbid obesity | ||
*Uncooperative patient | *Uncooperative/combative patient | ||
{{Central line with coagulopathy}} | {{Central line with coagulopathy}} | ||
Latest revision as of 14:53, 24 April 2021
Contraindications
Absolute[1]
- Infection over the placement site
- Anatomic obstruction (thrombosis of target vein, other anatomic variance)
- Site-specific
- Subclavian - trauma/fracture to ipsilateral clavicle or proximal ribs
Relative
- Coagulopathy (see below)
- Distortion of landmarks by trauma or congenital anomalies
- Prior vessel injury or procedures
- Morbid obesity
- Uncooperative/combative patient
Central line if coagulopathic
- Preferentially use a compressible site such as the femoral location (avoid the IJ and subclavian if possible, though IJ preferred over subclavian)
- No benefit to giving FFP unless artery is punctured[2]
- However, consider giving FFP if patient has hemophilia[3]
- ↑ Graham, A.S., et al. Central Venous Catheterization. N Engl J Med 2007;356:e21
- ↑ Fisher NC, Mutimer DJ. Central venous cannulation in patients with liver disease and coagulopathy—a prospective audit. Intens Care Med 1999; 25:5
- ↑ Morado M.et al. Complications of central venous catheters in patients with haemophilia and inhibitors. Haemophilia 2001; 7:551–556