The axillary vein central venous catheter in severely burned patients

In severely burned patients the approach to the central vein is often diffi cult due to concomitant edema, but also due to the fact that the skin area, where commonly used approaches are performed, is burned as well, whereas t he axillary region is often not involved. In order to perform an axillary a pproach to th: central vein as an alternative to the commonly used approach es in patients, an anatomical dissection in fresh human cadavers was carrie d out. Considering the anatomical landmarks which were found during dissect ion of the axillary region, the axillary approach to the central vein was u sed in 35 patients in our intensive burn care unit with unaffected axillary skin. In three cases the only complication observed was an occasional punc ture of the axillary artery without major hematoma. The infection rate of t he catheters was similar to the commonly used puncture sites. This approach to the central venous line in severely burned, patients can be recommended . (C) 1999 Elsevier Science Ltd and ISBI. All rights reserved.