Can you justify not using ultrasound guidance for central venous access?
- PMID: 17129362
- PMCID: PMC1794450
- DOI: 10.1186/cc5079
Can you justify not using ultrasound guidance for central venous access?
Abstract
Karakitsos and coworkers, in this journal, reported further compelling evidence on the value of ultrasound in guiding internal jugular vein catheterization. In a large, prospective, randomized study of 900 patients, comparisons were made between patients in whom the procedure was performed using landmark-based techniques and those assigned to ultrasound guidance. The key benefits from use of ultrasound included reduction in needle puncture time, increased overall success rate (100% versus 94%), reduction in carotid puncture (1% versus 11%), reduction in carotid haematoma (0.4% versus 8.4%), reduction in haemothorax (0% versus 1.7%), decreased pneumothorax (0% versus 2.4%) and reduction in catheter-related infection (10% versus 16%). The implications of these findings are discussed, and a compelling case for routine use of ultrasound to guide central venous access is made.
Comment on
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Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients.Crit Care. 2006;10(6):R162. doi: 10.1186/cc5101. Crit Care. 2006. PMID: 17112371 Free PMC article. Clinical Trial.
References
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- Karakitsos D, Labropoulos N, De Groot E, Patrianakos AP, Kouraklis G, Poularas J, Samonis G, Tsoutsos DA, Konstadoulakis MM, Andreas Karabinis A. Real-time ultrasound guided catheterization of the internal jugular vein: a prospective comparison to the landmark technique in critical care patients [ISRCTN61258470] Crit Care. 2006;10:R162. doi: 10.1186/cc5101. - DOI - PMC - PubMed
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- National Institute for Clinical Excellence . Guidance on the Use of Ultrasound Locating Devices for Central Venous Catheters (NICE technology appraisal, No 49) London, UK: NICE; 2002.
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