• Ori Galante, Tzachi Slutsky, Lior Fuchs, Alexander Smoliakov, Yuval Mizrakli, Victor Novack, Evgeni Brotfein, Moti Klein, Amit Frenkel, Leonid Koifman, and Yaniv Almog.
• 1Medical Intensive Care Unit, Soroka University Medical Center; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel. 2Department of Medicine, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel. 3Institute of Diagnostic Radiology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel. 4Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel. 5Surgical Intensive Care Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
• Crit. Care Med. 2017 Oct 1; 45 (10): e994-e1000.

ObjectivesTo evaluate whether a single-operator ultrasound-guided, right-sided, central venous catheter insertion verifies proper placement and shortens time to catheter utilization.DesignProspective observational study with historical controls.SettingAdult ICUs.PatientsSixty-four consecutive patients undergoing ultrasound-assisted right-sided central venous catheterization compared with 92 serial historic controls who had unassisted central catheter insertion at the same sites.InterventionsSubcostal transthoracic echocardiography during catheter insertion.Measurements And Main ResultsThe primary outcome was the correct placement of the catheter tip determined by postprocedural chest radiography. The subclavian site was used in 41 patients (64%) (inserted without ultrasound guidance) in the ultrasound-assisted group and 62 (67%) in the control group, whereas the jugular vein was used in the remaining patients. The tip was accurately positioned in 59 of 68 patients (86.7%) in the ultrasound-assisted group compared with 51 of 94 (54.8%) in the control group (p < 0.001). The median time from end of the procedure to catheter utilization after chest radiography approval was 2.4 hours.ConclusionsA single-operator ultrasound-guided central venous catheter insertion is effective in verifying proper tip placement and shortens time to catheter utilization.

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