English abstract
SUBCLAVIAN LINE PLACEMENT IS A COMMON procedure and complications, including catheter tip displacement, are rare. In the supine posture, the breasts in obese female patients placed in the standard recommended position for the subclavian line placement may allow a successful uneventful procedure. However once the patient assumes a sitting or an erect position, due to the lax skin and the weight of the breast, the site of insertion and anchorage on the skin moves down considerably. This leads to a loss in length of the intravascular part of the central venous (CV) catheter. cautions are recommended: 1. In obese female patients, the subclavian CV catheter can be inserted while taking into account the displaced position of the breast which tends to slip laterally and upwards in the supine position. An assistant may retract the breast downwards and medially while selecting the position of insertion on the skin. 2. A chest X-Ray should be done to confirm the CV catheter position in the sitting or erect position in such patients. 3. Jugular line placement may be an alternative in these types of patients.
