A large retrospective, multicenter, observational study of 10 949 central venous catheter insertions demonstrated a lower risk of mechanical complications in hospitalized patients. However, the incidence of mechanical complications can be influenced by some additional risk factors.

The central venous catheter is considered as a risk-free procedure as incidences of mechanical complications during its insertion are very rare. Some of the previously conducted small cohorts diagnosed some complications during central venous catheter implementations. Malin Björkander and colleagues conducted a multicenter observational study in a large group of patients to determine central venous catheter-related risk factors and problems like mechanical complications.

The data for analysis was included from 8 southern Sweden hospitals from the year 2013 to 2016.  The information related to use of ultrasonography, blood coagulation tests, number of needle passes, bore size, central venous catheter location, the chronological order of the central venous catheter insertion, mechanical complications and arterial puncture was involved. Mechanical complications such as nerve injury, malignant arrhythmia, pneumothorax and bleeding were considered as primary outcomes. Other complications like persistent nerve injury, bleeding that needed transfusion or treatment and non-self-limiting arrhythmia were marked as severe mechanical issues of the central venous catheter.

Out of 10949 catheter insertions, only 118 cases exhibited mechanical complications. Eighty-five patients showed bleeding, 21 exhibited pneumothoraces, 7 showed nerve injuries, and 5 showed self-limiting arrhythmia. Only 23 cases reflected severe problems. Grade 2-4 bleeding was related to arterial puncture, a number of needle passes and preprocedural coagulopathy approaches and pneumothorax related to the chronological order of the central venous catheter insertion, subclavian vein insertions and arterial puncture modalities. Very few cases were noticed out of the large population, and this shows central venous catheter is a safe insertion method.