Several million central venous catheters are placed annually in US. The procedure is regarded as overall safe when using ultrasound guidance technique. Recent article in Critical Care questions this assumption stating that posterior venous wall penetration was noted in 64% of cases. That complication would be clinically significant if carotid artery (with internal jugular vein approach) is dilated or cannulated. It’s hard to imagine that in 64% of cases the carotid artery is being penetrated or even dilated. I always confirm the line placement by observing the color of the blood and confirming a lack of pulsatile flow. Nevertheless, interesting findings reported in this paper.
Is this really relevant to the real world practice???