A 33-year-old male was admitted to the Intensive Care Unit due to respiratory distress secondary to Legionella pneumonia, requiring neuromuscular block and prone decubitus upon admission. We conducted prior ultrasound-guided catheterization of the right cephalic vein at its final portion where the vessel drains into the subclavian vein. The Fig. 1 and Video 1 show a longitudinal view of the catheter guide crossing the junction of the cephalic and axillary veins towards the right subclavian vein. Correct positioning was confirmed radiographically (Fig. 1). Such catheterization offers an ultrasound-guided alternative to the infraclavicular subclavian vein, which is not always accessible to ultrasound, posing an increased risk of pneumothorax that should be avoided in patients with severe respiratory failure. On the other hand, positioning is more accessible during prone decubitus compared with other venous accesses (Supplementary images).

Figure 1