Trial reportCritical care (London, England)2025
Site-specific complications of central venous catheterization under systematic ultrasound guidance: a target trial emulation revisiting the 3SITES study.
Trial report in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Revisiting subclavian access in the ultrasound era: are we comparing sites or techniques? Author's reply.Critical care (London, England) · 2026Article
- Revisiting subclavian access in the ultrasound era: are we comparing sites or techniques?Critical care (London, England) · 2026Article
- Real-time ultrasound-guided subclavian vein cannulation: should it be the preferred method for central venous catheterization in critically ill?Critical care (London, England) · 2025Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCentral venous catheterization is the most common invasive procedure in intensive care units but remains burdened by infectious, thrombotic, and mechanical complications. Although real-time ultrasound guidance is now widely adopted, its effect on site-specific differences in overall complication rates has not been established. The 3SITES randomized clinical trial previously demonstrated lower infection and thrombosis rates with subclavian access but higher mechanical complications. However, as only a third of its procedures were ultrasound-guided in this study, these findings may not apply to current practice. The objective of the study was to compare complication rates across these three sites under a counterfactual framework assuming universal ultrasound guidance.
methodsThis study was an emulated a target trial using the 3SITES dataset. Inverse probability weighting was applied to adjust for confounders of site assignment and ultrasound guidance. Weighted outcomes across catheter sites were compared under a counterfactual framework assuming universal ultrasound guidance. The primary outcome was a composite of time to catheter-related bloodstream infection or symptomatic deep-vein thrombosis. Secondary outcomes included each component separately, asymptomatic thrombosis, and major mechanical complications.
resultsA total of 3409 catheters were included: 1153 in the femoral, 1267 in the internal jugular, and 989 in the subclavian site. Subclavian site showed a lower incidence of the primary outcome compared with femoral (P = .02) and jugular (P = .001) sites. The primary composite outcome did not differ between internal jugular and femoral sites (P = .97). Catheter-related bloodstream infections were significantly fewer with subclavian versus jugular access (P = .001). Asymptomatic thrombosis was more frequent at femoral and jugular sites. Major mechanical complications were rare and did not differ significantly across sites.
conclusionAssuming universal real-time ultrasound-guided central venous catheterization, subclavian access retains lower infectious and thrombotic risk without an observed increase in mechanical complications, supporting its preferential use in intensive care units.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.