Ultrasonic locating devices for central venous cannulation: meta-analysis

Hind, Daniel

doi:10.1136/bmj.327.7411.361

Cited by 968 publications

(601 citation statements)

References 7 publications

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“…11 However, there is still limited use of ultrasound in current practice. 12 The results of our study support the use of real-time ultrasound for CVC in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound simulation of internal jugular vein cannulation in pregnant and non-pregnant women

Siddiqui

Goldszmidt

Haque

et al. 2010

Can J Anesth/J Can Anesth

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Background Pregnancy alters the anatomic landmarks for internal jugular vein (IJV) cannulation. In this study, IJV cannulation was simulated, and success of the technique was evaluated using ultrasound. Methods Term pregnant women and non-pregnant female volunteers were recruited. The degree of difficulty in assessing neck anatomy was noted. The optimal insertion points for cannulation were marked on the skin of each subject according to the central landmark and palpatory techniques. The midpoint of a 15-10 MHz linear transducer was placed over each insertion point, and the vertical cursor of the ultrasound, which represented the path of the needle, was placed in the image. The outcome was an IJV puncture, a carotid artery (CA) puncture, or a missed attempt. Results One hundred and sixty-one women, 99 pregnant and 62 non-pregnant, were studied. The identification of landmarks was more difficult in pregnant women (P = 0.01). The rates of successful IJV punctures, CA punctures, and missed attempts did not differ significantly between pregnant and non-pregnant women. Carotid artery punctures using the central landmark technique in pregnant and non-pregnant subjects were 19% and 10%, respectively. Corresponding figures for the palpatory approach were 6% and 3%, respectively. The degree of IJV overlap of the CA in the palpatory technique was greater in pregnant women (38% vs 18% showed [ 75% overlap; P \ 0.001), a difference that remained after controlling for body mass index Conclusion The IJV overlies the CA to a greater extent in pregnant patients than in non-pregnant patients. Thus, a landmark approach for IJV cannulation might expose pregnant women to a greater risk of carotid puncture. This trial was registered at www.clinicaltrials.gov (NCT T00464828).

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“…11 However, there is still limited use of ultrasound in current practice. 12 The results of our study support the use of real-time ultrasound for CVC in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound simulation of internal jugular vein cannulation in pregnant and non-pregnant women

Siddiqui

Goldszmidt

Haque

et al. 2010

Can J Anesth/J Can Anesth

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“…5,6 Ultrasound techniques As early as 1978, ultrasound-guided central catheterization was described as an effective technique to reduce the rate of mechanical complications. 7 Ullman et al were among the first to describe the use of a Doppler probe for central catheterization. 8 Then, in 1984, Legler and Nugent published the first guidelines on the use of Doppler ultrasound.…”

Section: Internal Jugular Vein Catheterizationmentioning

confidence: 99%

“…1,5,7 The benefits include a reduced rate of complications and failure, a reduced number of attempts, and a faster performance time. [21][22][23][24] These results are due to visualization of the needle and its position relative to the structures.…”

Section: Benefitsmentioning

confidence: 99%

“…25 Also, according to Hind et al and Calvert et al, there were 86% fewer failures and 41% fewer failures on the first attempt. 7,26 These studies were used to establish the 2003 National Institute for Clinical Excellence recommendations. In a study evaluating lawsuits, Domino et al concluded that the use of ultrasound could have prevented incidents in 28 patients out of 110 patients involved in a legal action.…”

Section: Benefitsmentioning

confidence: 99%

“…5,6 Techniques échographiques Dès 1978, l'insertion de cathéters centraux sous repérage échographique apparaît comme une intervention efficace pour diminuer le taux de complications mécaniques. 7 En effet, Ullman et coll. font partie des pionniers à décrire l'emploi d'une sonde Doppler dans la pose des cathéters centraux.…”

Section: Canulation De La Veine Jugulaire Interneunclassified

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Ultrasound guidance for internal jugular vein cannulation: Continuing Professional Development

Ayoub

Lavallée

Denault

2010

Can J Anesth/J Can Anesth

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Purpose The objective of this continuing professional development module is to describe the role of ultrasound for central venous catheterization and to specify its benefits and limitations. Although ultrasound techniques are useful for all central venous access sites, the focus of this module is on the internal jugular vein approach. Principal findings In recent years, several studies were published on the benefits of ultrasound use for central venous catheterization. This technique has evolved rapidly due to improvements in the equipment and technology available. Ultrasound helps to detect the anatomical variants of the internal jugular vein. The typical anterolateral position of the internal jugular vein with respect to the carotid is found in only 9-92% of cases. Ultrasound guidance reduces the rate of mechanical, infectious, and thrombotic complications by 57%, and it also reduces the failure rate by 86%. Cost-benefit analyses show that the cost of ultrasound equipment is compensated by the decrease in the expenses associated with the treatment of complications. In this article, we will review the history of ultrasound guidance as well as the reasons that account for its superiority over the classical anatomical landmark technique. We will describe the equipment needed for central venous catheterization as well as the various methods to visualize with ultrasound. Conclusion To improve patient safety, we recommend the use of ultrasound for central venous catheterization using the internal jugular approach. ObjectivesAfter reading this module, the reader will be able to:1. Understand the rationale behind the use of ultrasound for central venous catheterization; 2. Identify anatomical variations in vascular structures in the neck; 3. Recognize the benefits and limitations related to the use of ultrasound; and 4. Adopt an ultrasound-guided approach in everyday practice.Over the years, anesthesiologists have adopted new technologies that are used for clinical monitoring and intraoperative diagnosis as well as for performing various techniques. These advances assist the anesthesiologist in performing procedures that may be associated with significant complications. One such procedure is central venous catheterization, which can be simplified and made safer with ultrasound. The main objective of this article is to explain the scientific and clinical foundations supporting the role of ultrasound in central venous catheterization. We will focus exclusively on the internal jugular vein approach. 123 Can J Anesth/J Can Anesth (2010) 57:500-514 DOI 10.1007/s12630-010-9291-7 Historical perspectiveThe main indications for central venous catheterization in the operating room or intensive care unit (ICU) include central venous pressure monitoring, the insertion of a pulmonary artery catheter, and the administration of drugs, such as antibiotics, vasopressors, inotropes, and chemotherapeutic agents. These catheters are also used to administer parenteral nutritional support, and they are needed for procedures such as...

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Pneumothorax Following Thoracentesis

Feller‐Kopman²,

et al. 2010

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Iatrogenic pneumothorax is a common complication of thoracentesis and frequently requires chest tube insertion. Real-time ultrasonography use is a modifiable factor that reduces the pneumothorax rate. Performance of thoracentesis for therapeutic purposes and in patients undergoing mechanical ventilation confers a higher likelihood of pneumothorax. Experienced operators may have lower pneumothorax rates. Patient safety may be improved by changes in clinical practice in accord with these findings.

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Ultrasonic locating devices for central venous cannulation: meta-analysis

Abstract: Objectives To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation.

Cited by 968 publications

References 7 publications

Ultrasound simulation of internal jugular vein cannulation in pregnant and non-pregnant women

Ultrasound simulation of internal jugular vein cannulation in pregnant and non-pregnant women

Ultrasound guidance for internal jugular vein cannulation: Continuing Professional Development

Pneumothorax Following Thoracentesis

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