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To the Editor: In a randomized trial of femoral vs jugular venous catheterization for short-term dialysis access, Dr Parienti and colleagues¹ concluded that jugular venous catheterization resulted in more mechanical complications, specifically hematomas. Additionally, they found no difference in the overall rate of catheter colonization, although this varied based on body mass index.

The authors noted that "[t]he mechanical complication rate reported for the jugular group might be overestimated" since very few catheters were placed under ultrasound guidance. However, the catheter colonization rate may also be overstated for the jugular position for the same reason. In a large randomized trial of ultrasound vs the landmark technique for insertion of jugular venous catheters, significantly fewer infections were found in the ultrasound group, possibly due to the fewer skin punctures required when ultrasound was used.² The results of the study by Parienti et al may not be applicable to centers where ultrasound . . . [Full Text of this Article]

Lewis Eisen, MD
leisen@gmail.com
Department of Critical Care Medicine
Montefiore Medical Center
Bronx, New York

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Femoral vs Jugular Venous Catheterization and Risk of Nosocomial Events in Adults Requiring Acute Renal Replacement Therapy: A Randomized Controlled Trial
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