Punção venosa guiada por ultra-som em unidade de terapia intensiva

Abstract

Use of ultrasound introduced as part of intensive care therapy makes viable bedside invasive procedures and diagnosis. Due to portability, combined with team training, its use guarantees less complications related to insertion, as well as patients' safety. It also reduces severe conditions related to the catheter, such as pneumothorax among others. Probably, in a near future, as purchase of ultrasound equipment becomes easier and team training more adequate, this tool will become essential in daily clinical practice.

A Comparative Study between Two Central Venous Access Techniques Performed by Junior Residents

“…Ultrasound-guided CVA is a helpful technique to gain CVAs [21] and the learning process of ultrasound-guided CVAs appears safe and feasible for training medical residents [16]. Although the ultrasound-guided techniques already has been incorporated into our currently developing medical residency program in general surgery, unfortunately, ultrasound devices had not been easily available for our residents at the time of this study.…”

Acesso venoso central guiado por ultrassom: qual a evidência?

“…However, there is still resistance to adopting this recommendation, and the ultrasound-guided technique is not widely used, (4,11) likely because of cost-related concerns and because of time and training requirements. (5,12,17) The difficulty of implementing research findings into clinical practice is well known. This difficulty is particularly true for critically ill patients, where interventions may have an immediate and significant impact on mortality.…”

“…This is the most studied site for ultrasound support use. (5,12) Ultrasound can be either "static" (vessel identification and location before puncturing) or "dynamic" (real-time, i.e., during the puncture). According to the study by Milling et al, in which 201 patients were randomized into 3 groups (anatomical landmarks, static ultrasound and dynamic ultrasound), the best results, accordingly controlled by a pre-test difficulty evaluation, were achieved using the dynamic technique, with a success ratio of 53.5 (95%CI 6.6-440) and a first attempt cannulation rate of 5.8 (95%CI 2.7-13) compared to the use of anatomical landmarks alone.…”

Landmark Central Venous Catheterization is Effective but Ultrasound Helps Even in Experienced Hands

“…The use of ultrasound to aid in Internal Jugular Vein (IJV) catheterization has been shown to improve success rates and decrease the need for multiple attempts, but it has not been adopted worldwide, possibly because of cost and training issues. [1][2][3] Additionally, the Center for Disease Control and Prevention (CDC) of the United States of America recommends the Subclavian Vein (SV) site as the preferred choice for CVCs due to lower infection rates compared to other puncture sites. 1 However, for placing lines at the subclavian site, ultrasound is not very helpful.…”