What is the clinical evidence from this study?

Study design: Letter. Population: Central venous catheterization (n=50). Intervention: Ultrasound-guided subclavian access vs. Anatomical landmark technique. Primary outcome: Mechanical complications.

What question did this study set out to answer?

The response addresses the ongoing debate on the optimal subclavian access site and technique using ultrasound guidance.

March 9, 2026Open Access

Revisiting subclavian access in the ultrasound era: are we comparing sites or techniques? Author’s reply

Key Result

Ultrasound-guided subclavian access mitigated the historical risk of mechanical complications, with zero events observed in the 50 patients receiving this technique.

Key Points

The response addresses the ongoing debate on the optimal subclavian access site and technique using ultrasound guidance.
Review of ultrasound application in subclavian access
Discussion of various catheterization techniques
Analysis of access site efficacy based on recent findings.
Ultrasound guidance improves placement success rates in subclavian access.
Comparison of techniques shows variations in complication rates and effectiveness.
Recommendations for optimal approaches are provided based on evidence.

Structured PICO

Does ultrasound-guided subclavian access improve the safety profile (reduce mechanical, infectious, and thrombotic complications) compared to internal jugular and femoral sites in ICU patients?

Population

50 patients receiving ultrasound-guided subclavian central venous catheterization in an intensive care unit setting.

Exposure

Ultrasound-guided subclavian (infraclavicular) access

Comparator

Internal jugular and femoral sites, or anatomical landmark technique

Outcome

Overall safety profile (mechanical, infectious, and thrombotic complications)safety

Ultrasound-guided infraclavicular subclavian access mitigates historical mechanical risks, potentially offering a superior safety profile regarding infectious and thrombotic complications compared to other sites.

Limitations

Small number of ultrasound-guided subclavian punctures (n=50) restricted the number of covariates in adjustment models
Zero events in the subclavian group prevented the reliable estimation of hazard ratios
Observational analysis limitations despite target trial emulation design

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Cite This Study

Boulet et al. (Thu,) conducted a letter in Central venous catheterization (n=50). Ultrasound-guided subclavian access vs. Anatomical landmark technique was evaluated on Mechanical complications. Ultrasound-guided subclavian access mitigated the historical risk of mechanical complications, with zero events observed in the 50 patients receiving this technique.

synapsesocial.com/papers/69af23813eac3accde8a179f https://doi.org/https://doi.org/10.1186/s13054-026-05937-7