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Traditional patient positioning for infraclavicular subclavian vein catheterization involves placing a rolled towel or saline bag longitudinally between the scapulae to create a retracted shoulder position; however, there is little scientific evidence to support this practice.
In a noninferiority study, researchers in Korea compared neutral shoulder and retracted shoulder positions during anatomical-landmark–guided catheterization of the subclavian vein in 362 patients (age range, 16–82) undergoing elective surgery. Patients were randomized to a neutral position, with head elevated on a 5-cm headrest, or a retracted position, with a 1-L bag of normal saline placed between the scapulae and head elevated on a 9-cm headrest. The primary endpoin…