Evidence map›Paper›PMID 39592540›Full record

ArticleNeurocritical care2025

Jugular Venous Catheterization is Not Associated with Increased Complications in Patients with Aneurysmal Subarachnoid Hemorrhage.

Feras Akbik, Yuyang Shi, Steven Philips, Cederic Pimentel-Farias, Jonathan A Grossberg, Brian M Howard, Frank Tong, C Michael Cawley, Owen B Samuels, Yajun Mei and 1 more

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In one paragraph

Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Feras AkbikDivision of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Yuyang ShiH. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Steven PhilipsDivision of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Cederic Pimentel-FariasDivision of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Jonathan A GrossbergDepartment of Neurosurgery, Emory University Hospital and School of Medicine, Atlanta, GA, USA.
Brian M HowardDepartment of Neurosurgery, Emory University Hospital and School of Medicine, Atlanta, GA, USA.
Frank TongDepartment of Neurosurgery, Emory University Hospital and School of Medicine, Atlanta, GA, USA.
C Michael CawleyDepartment of Neurosurgery, Emory University Hospital and School of Medicine, Atlanta, GA, USA.
Owen B SamuelsDivision of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA.
Yajun MeiH. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, USA.
Ofer SadanDivision of Neurocritical Care, Department of Neurology and Neurosurgery, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA, 30322, USA. ofer.sadan@emory.edu.ORCID 0000-0002-0050-3025

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClassic teaching in neurocritical care is to avoid jugular access for central venous catheterization (CVC) because of a presumed risk of increasing intracranial pressure (ICP). Limited data exist to test this hypothesis. Aneurysmal subarachnoid hemorrhage (aSAH) leads to diffuse cerebral edema and often requires external ventricular drains (EVDs), which provide direct ICP measurements. Here, we test whether CVC access site correlates with ICP measurements and catheter-associated complications in patients with aSAH.

methodsIn a single-center retrospective cohort study, patients with aSAH admitted to Emory University Hospital between January 1, 2012, through December 31, 2020, were included. Patients were assigned by the access site of the first CVC placed. The subset of patients with an EVD were further studied. ICP measurements were analyzed using linear mixed effect models, with a binary comparison between internal-jugular (IJ) versus non-IJ access.

resultsA total of 1577 patients were admitted during the study period with CVC access: subclavian (SC) (887, 56.2%), IJ (365, 23.1%), femoral (72, 4.6%), and peripheral inserted central catheter (PICC) (253, 16.0%). Traumatic pneumothorax was the most common with SC access (3.0%, p < 0.01). Catheter-associated infections did not differ between sites. Catheter-associated deep venous thrombosis was most common in femoral (8.3%) and PICC (3.6%) access (p < 0.05). A total of 1220 patients had an EVD, remained open by default, generating 351,462 ICP measurements. ICP measurements, as compared over the first 24-postinsertion hours and the next 10 days, were similar between the two groups. Subgroup analysis accounting for World Federation of Neurological Surgeons grade on presentation yielded similar results.

conclusionsContrary to classic teaching, we find that IJ CVC placement was not associated with increased ICP in the clinical context of the largest, quantitative data set to date. Further, IJ access was the least likely to be associated with an access-site complication when compared with SC, femoral, and PICC. Together, these data support the safety, and perhaps preference, of ultrasound-guided IJ venous catheterization in neurocritically ill patients.

Indexed as

Catheterization, Central VenousCatheterization, PeripheralIntracranial PressureJugular VeinsSubarachnoid HemorrhageAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesAneurysmCentral venous catheterizationIntracranial pressureSubarachnoid hemorrhage

Identifiers

PMID39592540
PMCPMC12137458

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.