What is your preferred site for central venous access in patients with concern for raised intracranial pressures?

Subclavian is our preferred central venous access for raised ICP, but we also utilize femoral lines for patients at high risk of pneumothorax or who need more emergent access. We have historically avoided IJ lines because of concern for impeding venous drainage by blocking the IJ. I do not think this is entirely supported by data, and certainly, many of us trained when we were placing jugular bulbs into the IJ to measure SjvO2, and those patients often had ICP issues.

The 3SITEs trial (Parienti e...