Central venous catheterization is a common procedure done in health care facilities to provide supportive and interventional therapies to patients. The veins usually catheterized are internal jugular vein, subclavian vein, and femoral vein. Common indications for the requirement of central venous access are limited peripheral venous access, administration of drugs like inotropes or vasopressors, highly osmotic or caustic drugs/fluids, volume resuscitation or blood product administration, central venous pressure monitoring amongst others.² Most central line are placed using Seldinger’s technique (safer than previous “cut-down”) in which a central vein is cannulated using a needle and a guide wire is passed through the needle to maintain the tract. Later, a multi-lumen catheter is passed over the guidewire before removal of guidewire. Cannulation is usually performed under sonographic guidance unless the ultrasound machine is unavailable, or the circumstances doesn’t allow the use of ultrasound. In such scenarios, landmark technique is used to cannulate a vein. Despite the use of ultrasound and overall safety of this procedure, complications do occur.³

Complications can be divided into immediate or delayed and further into infectious, mechanical and thrombotic. As it takes time for the microbes to grow on catheter, thus immediate infectious complications are negligible.

There are few mechanical and thrombo-embolic complications that can occur at the time of central vein cauterization or in the immediate post procedure time. Thrombo-embolic complications like air embolism or guide wire embolism and mechanical complications like arterial puncture, hemorrhage, intra-arterial placement of catheter, haemothorax, pneumothorax, arrhythmias, injury to thoracic duct and cardiac tamponade can occur with varying incidence and severity.⁴ Therefore, we have planned this study to evaluate the incidence of complications of CVC and the risk factors associated along with in our tertiary care centre since similar data has not previously been collected and evaluated.

Although central line insertion is a common practice for gaining vascular access but associated with numerous complications. Complications related to CVC increase the morbidity and mortality of the patients leading to increased hospital stay.

A study conducted by Babu et al in 2018, compared the outcomes, cost and patient satisfaction scores in patients receiving CVC vs. chemoport in situ and concluded that CVC/PICC are more convenient as compared to the chemoport for venous access in chemotherapy patients.⁵ A systematic review done by Ullman et al in 2015 collected data of CVC failure and complication rate in paediatric population before completion of therapy.⁶ Kaur et al conducted a study in intensive care unit of teritary care hospital and concluded that bleeding complications occurred more frequently with IJV insertions and infectious complications occurred more commonly in cannulae that were left in situ for longer than 7 days.⁷ A retrospective clinical audit was done by Agarwal et al in 2012 to assess the incidence of malposition of CVC using a landmark technique. They also found a correlation between the experience of the operator and the number of complications encountered by them.⁸