Abstract

PAEZ, Andrés et al. Comparación de la incidencia de complicaciones entre residentes y especialistas en la cateterización venosa central en un hospital universitario . Rev. colomb. anestesiol. [online]. 2006, vol.34, n.2, pp.89-93. ISSN 0120-3347.

Central venous catheterization is essential for the management of many patients. This procedure is made daily in the critical care units, operating rooms, and emergency rooms. It has inherent risks, which can lead to serious complications. During training, residents must develop abilities and skills to perform the procedure, following the protocols in order to avoid possible risks and complications. Objective: To evaluate the quality of theeducational process of central venous catheterization, in terms of safety for the patient in the Universitary Hospital Fundación Santa Fe de Bogotá. Methods: Analytic cohort study. All the patients subjected to central venous catheterization during the period October 1991 through October 2004 in Fundación Santa Fe de Bogotá were included. The incidence of major mechanical complications (pneumothorax, quilothorax and haemothorax) were compared, both in the specialists and residents groups. Additionally, a stratified analysis was made, according to the route of insertion as well as the incidence of catheter related bacteremia. Results: During the study period, 6532 catheters were inserted, of which 2860 (43.78%) were placed by specialists and 3672 (56.22%) by residents. Sixty major mechanical complications were registered, of which 38 belonged to residents and 22 to specialists. Relative risk: 0.73; CI 95 (0.40; 1.35). When the stratified analysis for the different routes of insertion was made, no statistical differences were found. Statistical differences were found in bacteremia related to the catheter among both groups. In the specialists group 14 bacteremias were reported while in the residents group, 96 bacteremias. Relative risk 0.19; CI 95% 0.11-0.33. Conclusions: During the process of central venous catheterization, the supervised training of residents, together with the strict accomplishment of the norms settled, is not an additional risk factor for the development of major mechanical complications: haemothorax, quilothorax and neumothorax. Nevertheless, aseptic techniques must be followed by the trainees.

Keywords : Central venous catheters; complications; training.

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