Indications, management, and complications of percutaneous subclavian catheters. An audit.

A retrospective outcome-oriented audit was conducted to determine the complications associated with percutaneous infraclavicular subclavian catheters in a university hospital. The study is unique since patients having these catheters were not under the care of a select group of physicians and the patients were not restricted to a special nursing unit. One hundred and seventeen catheters were placed in 68 patients. Seventeen types of complications were audited. There were 13 complications (11%) identified as follows: pneumothorax, seven; subcutaneous emphysema, one; subclavian artery hematoma, one; pleural effusion, one; improper position, two; and sepsis, one. No mortality was associated with catheter placement. Pattern analysis suggested physician inexperience as an important cause of complications. The difficulties of establishing a retrospective audit based on documentation errors and omissions are discussed.