Bibliographic information
GuidelineGuidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part 2: central venous catheters
Year of Publication2026
Issuing InstitutionWorld Health Organization
Recommendation
New
WHO suggests using the subclavian veins as the preferred site over jugular veins (if no contraindications) for central venous catheter (CVC) insertion in adults, adolescents, children and neonates. (Short- and long-term catheters) (All population)
Recommended in favor
Conditional
Certainty of evidence
Low
Notes and Remarks
- The GDG acknowledged the potential increased risk of mechanical complications (particularly pneumothorax) when using the subclavian veins, but reducible with appropriate training and the use of ultrasound. The expected dwell time of the CVC was judged as an important factor to be taken into consideration. In the case of shorter dwell times and the smaller likelihood of developing an infection, the jugular site may be considered more appropriate, despite the overall recommendation.
- Insertion into the subclavian site is technically more difficult and requires additional and appropriate training.
- The subclavian site should be avoided in patients currently receiving or likely to require haemodialysis due to the risk of subclavian vein stenosis (201, 202).
- The subclavian vein should be avoided in patients with coagulopathy as it carries a higher risk of bleeding.