• Crit Care · Jan 2006

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    Can you justify not using ultrasound guidance for central venous access?

    • Andrew R Bodenham.
    • Department of Anaesthesia, Leeds General Infirmary, Leeds, LS1 3EX, UK. Andy.Bodenham@leedsth.nhs.uk
    • Crit Care. 2006 Jan 1;10(6):175.

    AbstractKarakitsos 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.

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