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      Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization

      Author(s): 1 , 2 , 3 , 4 , 5 , 6
      Editor(s): Cochrane Emergency and Critical Care Group
      Publication date (Electronic):
      Journal: Cochrane Database of Systematic Reviews
      Publisher: Wiley

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          Abstract

          Central venous catheters (CVCs) can help with diagnosis and treatment of the critically ill. The catheter may be placed in a large vein in the neck (internal jugular vein), upper chest (subclavian vein) or groin (femoral vein). Whilst this is beneficial overall, inserting the catheter risks arterial puncture and other complications and should be performed with as few attempts as possible. Traditionally, anatomical 'landmarks' on the body surface were used to find the correct place in which to insert catheters, but ultrasound imaging is now available. A Doppler mode is sometimes used to supplement plain 'two-dimensional' ultrasound.

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          Most cited references99

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          Ultrasonic locating devices for central venous cannulation: meta-analysis.

          Daniel Hind, Neill W Calvert, Richard McWilliams … (2003)
          To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation. 15 electronic bibliographic databases, covering biomedical, science, social science, health economics, and grey literature. Systematic review and meta-analysis of randomised controlled trials. Populations Patients scheduled for central venous access. INTERVENTION REVIEWED: Guidance using real time two dimensional ultrasonography or Doppler needles and probes compared with the anatomical landmark method of cannulation. Risk of failed catheter placement (primary outcome), risk of complications from placement, risk of failure on first attempt at placement, number of attempts to successful catheterisation, and time (seconds) to successful catheterisation. 18 trials (1646 participants) were identified. Compared with the landmark method, real time two dimensional ultrasound guidance for cannulating the internal jugular vein in adults was associated with a significantly lower failure rate both overall (relative risk 0.14, 95% confidence interval 0.06 to 0.33) and on the first attempt (0.59, 0.39 to 0.88). Limited evidence favoured two dimensional ultrasound guidance for subclavian vein and femoral vein procedures in adults (0.14, 0.04 to 0.57 and 0.29, 0.07 to 1.21, respectively). Three studies in infants confirmed a higher success rate with two dimensional ultrasonography for internal jugular procedures (0.15, 0.03 to 0.64). Doppler guided cannulation of the internal jugular vein in adults was more successful than the landmark method (0.39, 0.17 to 0.92), but the landmark method was more successful for subclavian vein procedures (1.48, 1.03 to 2.14). No significant difference was found between these techniques for cannulation of the internal jugular vein in infants. An indirect comparison of relative risks suggested that two dimensional ultrasonography would be more successful than Doppler guidance for subclavian vein procedures in adults (0.09, 0.02 to 0.38). Evidence supports the use of two dimensional ultrasonography for central venous cannulation.
          Article 0 comments Cited 178 times – based on 0 reviews     Review now
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            International evidence-based recommendations on ultrasound-guided vascular access.

            Jack LeDonne, Dimitrios Karakitsos, Mauro Pittiruti … (2012)
            To provide clinicians with an evidence-based overview of all topics related to ultrasound vascular access. An international evidence-based consensus provided definitions and recommendations. Medical literature on ultrasound vascular access was reviewed from January 1985 to October 2010. The GRADE and the GRADE-RAND methods were utilised to develop recommendations. The recommendations following the conference suggest the advantage of 2D vascular screening prior to cannulation and that real-time ultrasound needle guidance with an in-plane/long-axis technique optimises the probability of needle placement. Ultrasound guidance can be used not only for central venous cannulation but also in peripheral and arterial cannulation. Ultrasound can be used in order to check for immediate and life-threatening complications as well as the catheter's tip position. Educational courses and training are required to achieve competence and minimal skills when cannulation is performed with ultrasound guidance. A recommendation to create an ultrasound curriculum on vascular access is proposed. This technique allows the reduction of infectious and mechanical complications. These definitions and recommendations based on a critical evidence review and expert consensus are proposed to assist clinicians in ultrasound-guided vascular access and as a reference for future clinical research.
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              Systematic Reviews: Identifying relevant studies for systematic reviews

              K Dickersin, R Scherer, C. Lefebvre (1994)
              Article 0 comments Cited 149 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): 146518
                Title: Cochrane Database of Systematic Reviews
                Publisher: Wiley
                ISSN (Electronic): 14651858
                Publication date (Electronic): January 09 2015
                Affiliations
                [1 ]HELIOS Klinikum Krefeld; Department of Anaesthesiology, Intensive Care Medicine, and Pain Therapy; Lutherplatz 40 Krefeld Germany 47805
                [2 ]Witten/Herdecke University; IFOM - The Institute for Research in Operative Medicine, Faculty of Health, Department of Medicine; Ostmerheimer Str. 200 Cologne Germany 51109
                [3 ]University of Cologne; Institute of Medical Statistics, Informatics and Epidemiology; Kerpener Str. 62 Cologne NRW Germany 50937
                [4 ]Westdeutsches Lungenzentrum am Universitätsklinikum Essen, Klinik für Intensivmedizin und Respiratorentwöhnung; Ruhrlandklinik; Tüschener Weg 40 Essen Germany
                [5 ]Medizinisches Zentrum StädteRegion Aachen; Klinik für Anästhesie, Intensivmedizin und Notfallmedizin; Mauerfeldchen 25 Würselen Germany
                [6 ]Royal Lancaster Infirmary; Department of Anaesthesia; Ashton Road Lancaster Lancashire UK LA1 4RP
                Article
                DOI: 10.1002/14651858.CD006962.pub2
                PMC ID: 6517109
                PubMed ID: 25575244
                SO-VID: a582b2c7-f5a9-43e3-ae2c-5ae5250fa345
                Copyright © © 2015
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