• Lawrence M Gillman, Michael Blaivas, Jason Lord, Azzam Al-Kadi, and Andrew W Kirkpatrick.
• Department of Critical Care Medicine, University of Calgary, 1403 - 29 Street NW, Calgary, T2N 2T9, Canada. gillmanlm@yahoo.ca
• Scand J Trauma Resus. 2010 Jan 1;18:39.

BackgroundUltrasound guidance during central line insertion has significantly reduced complications associated with this procedure and has led to it being incorporated as standard of care in many institutions. However, inadvertent arterial penetration and dilation remains a problem despite ultrasound guidance and can result in significant morbidity and even mortality. Dynamic ultrasound confirmation of guidewire position within the vein prior to dilation may help to prevent and even eliminate this feared complication.MethodsA prospectively collected database of central line insertions for one author utilizing this novel technique was retrospectively reviewed for all incidents of arterial dilation over a period from September 2008 to January 2010.ResultsDuring the study period 53 central lines were inserted with no incidents of arterial dilation.ConclusionsUltrasound confirmation of guidewire position has the potential to reduce or eliminate the morbidity and mortality of arterial dilation during central line placement.

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