3SITES (femoral vs. jugular)
Trial question
Is femoral vein catheterization superior to jugular vein catheterization in ICU patients?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
36.0% female
64.0% male
N = 2285
2285 patients (816 female, 1469 male).
Inclusion criteria: adult patients in the ICU.
Key exclusion criteria: age ≤ 18 years; only one site available for catheterization.
Interventions
N=1140 femoral vein catheterization (catheter insertion in the femoral vein).
N=1145 jugular vein catheterization (catheter insertion in the jugular vein).
Primary outcome
Catheter-related bloodstream infection and symptomatic deep vein thrombosis
33 events
30 events
33.0 events
24.8 events
16.5 events
8.3 events
0.0 events
Femoral vein
catheterization
Jugular vein
catheterization
No significant
difference ↔
No significant difference in catheter-related bloodstream infection and symptomatic DVT (33 events vs. 30 events; HR 1.3, 95% CI 0.8 to 2.1).
Secondary outcomes
Significant increase in catheter tip colonization (145 events vs. 121 events; HR 1.6, 95% CI 1.2 to 2).
No significant difference in DVT (62 events vs. 78 events; HR 0.9, 95% CI 0.7 to 1.3).
No significant difference in major mechanical complications (7 events vs. 13 events; OR 0.5, 95% CI 0.2 to 1.4).
Conclusion
In adult patients in the ICU, femoral vein catheterization was not superior to jugular vein catheterization with respect to a catheter-related bloodstream infection and symptomatic DVT.
Reference
Jean-Jacques Parienti, Nicolas Mongardon, Bruno Mégarbane et al. Intravascular Complications of Central Venous Catheterization by Insertion Site. N Engl J Med. 2015 Sep 24;373(13):1220-9.
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