Introduction

During the past 40 years there has been an enormous increase in the use of central venous catheterization and cannulation devices for the management of critically ill patients. The introduction of these techniques has allowed the optimal adjustment of circulatory variables by direct hemodynamic measurement and volume replacement, infusion of a wide variety of pharmacologically active agents which cannot be satisfactorily infused via peripheral veins, and the provision of intravenous nutrition for prolonged periods of time. As with all procedures in surgery and medicine, drawbacks and complications have been recorded. Many of these have been iatrogenic in origin.

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