Ultrasound for central vascular access. A safety concept that is renewed day by day: review
Ultrasound (US)-guided central venous catheterization is intended to reduce complications, enhance success rates on the first attempt, and increase accuracy, thus becoming a standard in clinical practice.
To review the relevant literature on the importance of US as a guide to central venous access and to describe the benefits of this tool and the impact of its use on the safety of the procedure.
A narrative review of various medical literature databases and recognized guidelines (National Guideline Clearinghouse, New Zealand Guidelines, National Institute for Clinical Excellence, Cochrane, and JAMA).
High-quality evidence recommends US-guided inter nal jugular vein access as the preferred approach in routine practice. However, different other anatomical sites may be necessary for vascular access depending on the clinical setting. Related complications associated with landmark-guided techni ques range between 0.3% and 18.8% and depend on multiple conditions such as patient characteristics and access site. US has been associated with a reduction in the relative risk of complica tions, failed attempts, and failed first attempt of 57%, 86%, and 41%, respectively.
US should be used routinely in central vascular access. Current evidence supports this recommendation for the internal jugular vein approach, but no so for the other approaches, in cases of difficult or failed access using conventional approaches.
2. Bodenham Chair A, Babu S, Bennett J, Binks R, Fee P, Fox B, et al. Association of Anaesthetists of Great Britain and Ireland: Safe vascular access 2016. Anaesthesia 2016;71:573-585.
3. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev 2015;1: CD011447.
4. Randolph AG, Cook DJ, Gonzales CA, Pribble CG. Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med 1996;24:2053-2058.
5. Fragou M, Gravvanis A, Dimitriou V, Papalois A, Kouraklis G, Karabinis A, et al. Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med 2011; 39:1607-1612.
6. Hayashi H, Amano M. Does ultrasound imaging before puncture facilitate internal jugular vein cannulation? Prospective randomized comparison with landmark-guided puncture in ventilated patients. J Cardiothorac Vasc Anesth 2002;16:572-575.
7. Rabindranath KS, Kumar E, Shail R, Vaux E. Use of real-time ultrasound guidance for the placement of hemodialysis catheters: a systematic review and meta-analysis of randomized controlled trials. Am J Kidney Dis 2011;58:964-970.
8. Rando K, Castelli J, Pratt JP, Scavino M, Rey G, Rocca ME, et al. Ultrasound-guided internal jugular vein catheterization: a randomized controlled trial. Heart Lung Vessel 2014;6:13-23.
9. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database of Systematic Reviews 2015;1: CD006962.
10. Jenssen C, Brkljacic B, Hocke M, Ignee A, Piscaglia F, Radzina M, et al. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part VI - Ultrasound-Guided Vascular Interventions. Ultraschall Med 2016;37:473-476.
11. Matsushima K, Frankel HL. Bedside ultrasound can safely eliminate the need for chest radiographs after central venous catheter placement: CVC sono in the surgical ICU (SICU). J Surg Res 2010;163:155-161.
12. Abboud PA, Kendall JL. Ultrasound guidance for vascular access. Emerg Med Clin North Am 2004;22:749-773.
13. Benter T, Teichgraber UK, Kluhs L, Papadopoulos S, Kohne CH, Felix R, et al. Anatomical variations in the internal jugular veins of cancer patients affecting central venous access. Anatomical variation of the internal jugular vein. Ultraschall Med 2001; 22:23-26.
14. Vezzani A, Manca T, Vercelli A, Braghieri A, Magnacavallo A. Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications. J Ultrasound 2013;16:161-170.
15. Pittiruti M, Hamilton H, Biffi R, MacFie J, Pertkiewicz M. EspenESPEN Guidelines on Parenteral Nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clin Nutr 2009;28:365-377.
16. Ball RD, Scouras NE, Orebaugh S, Wilde J, Sakai T. Randomized, prospective, observational simulation study comparing residents’ needle-guided vs free-hand ultrasound techniques for central venous catheter access. Br J Anaesth 2012;108:72-79.
17. Shrestha GS, Gurung A, Koirala S. Comparison between long- and short-axis techniques for ultrasound-guided cannulation of internal jugular vein. Ann Card Anaesth 2016;19:288-292.
18. Batllori M, Urra M, Uriarte E, Romero C, Pueyo J, Lopez-Olaondo L, et al. Randomized comparison of three transducer orientation approaches for ultrasound guided internal jugular venous cannulation. Br J Anaesth 2016;116:370-376.
19. Tokumine J, Lefor AT, Yonei A, Kagaya A, Iwasaki K, Fukuda Y. Three-step method for ultrasound-guided central vein catheterization. Br J Anaesth 2013;110:368-373.
20. Merz E. [Transducer hygiene - an underrated topic?]. Ultraschall Med 2005;26:7-8.
21. Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G. Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion? Am J Respir Crit Care Med 2001;164:403-405.
22. Lichtenstein DA. Pneumothorax and the A'-Proile. Lung Ultrasound in the Critically Ill: The BLUE Protocol. 2016; Cham: Springer International Publishing, pp. 97-108.
23. Lanza C, Russo M, Fabrizzi G. Central venous cannulation: are routine chest radiographs necessary after B-mode and colour Doppler sonography check? Pediatr Radiol 2006;36:1252-1256.
24. Weekes AJ, Johnson DA, Keller SM, Efune B, Carey C, Rozario NL, et al. Central vascular catheter placement evaluation using saline flush and bedside echocardiography. Acad Emerg Med 2014;21: 65-72.
25. Sznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S. Central vein catheterization. Failure and complication rates by three percutaneous approaches. Arch Intern Med 1986;146:259-261.
26. Mansield PF, Hohn DC, Fornage BD, Gregurich MA, Ota DM. Complications and failures of subclavian-vein catheterization. N Engl J Med 1994;331:1735-1738.
27. Merrer J, De Jonghe B, Golliot F, Lefrant JY, Raffy B, Barre E, et al. Complications of femoral and subclavian venous catheterization in critically ill patients: a randomized controlled trial. JAMA 2001;286:700-707.
28. Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C, et al. Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ 2003;327:361.
29. National Institute for Clinical Excellence (NICE). Guidance on the Use of Ultrasound Locating Devices for Placing Central Venous Catheters. London UK: NICE; 2002. Technology appraisal guidance no. 49.
30. Theodoro D, Krauss M, Kollef M, Evanoff B. Risk factors for acute adverse events during ultrasound-guided central venous cannulation in the emergency department. Acad Emerg Med 2010;17:1055-1061.
31. Wu SY, Ling Q, Cao LH, Wang J, Xu MX, Zeng WA. Real-time two-dimensional ultrasound guidance forcentral venous cannulation: a meta-analysis. Anesthesiology 2013;118:361-375.
32. Mehta N, Valesky WW, Guy A, Sinert R. Systematic review: is real-time ultrasonic-guided central line placement by ED physicians more successful than the traditional landmark approach? Emerg Med J 2013;30:355-359.
33. Kaye AD, Fox CJ, Hymel BJ, Gayle JA, Hawney HA, Bawcom BA, et al. The importance of training for ultrasound guidance in central vein catheterization. Middle East J Anaesthesiol 2011;21:61-66.
34. Cavanna L, Civardi G, Vallisa D, Di Nunzio C, Cappucciati L, Berte R, et al. Ultrasound-guided central venous catheterization in cancer patients improves the success rate of cannulation and reduces mechanical complications: a prospective observational study of 1,978 consecutive catheterizations. World J Surg Oncol 2010;8:91.
35. Blaivas M, Brannam L, Fernandez E. Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model. Acad Emerg Med 2003;10:1307-1311.
36. Moon CH, Blehar D, Shear MA, Uyehara P, Gaspari RJ, Arnold J, et al. Incidence of posterior vessel wall puncture during ultrasound-guided vessel cannulation in a simulated model. Acad Emerg Med 2010;17:1138-1141.
37. Stone MB, Moon C, Sutijono D, Blaivas M. Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach. Am J Emerg Med 2010;28:343-347.
38. Lalu MM, Fayad A, Ahmed O, Bryson GL, Fergusson DA, Barron CC, et al. Ultrasound-Guided Subclavian Vein Catheterization: A Systematic Review and Meta-Analysis. Crit Care Med 2015; 43:1498-1507.
39. Mozersky DJ, Olson RM, Coons HG, Hagood COJr. Doppler-controlled needle director: a useful adjunct to angiography. Radiology 1973;109:221-222.
40. Hoffman T, Du Plessis M, Prekupec MP, Gielecki J, Zurada A, Tubbs RS, et al. Ultrasound-guided central venous catheterization: A review of the relevant anatomy, technique, complications, and anatomical variations. Clin Anat 2017;30:237-250.
41. Milone M, Di Minno G, Di Minno MN, Salvatore G, Iacovazzo C, Policastro C, et al. The real effectiveness of ultrasound guidance in subclavian venous access. Ann Ital Chir 2010;81:331-334.
42. Stone MB, Wang R, Price DD. Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med 2008;26:706-710.
43. Taylor BL, Yellowlees I. Central venous cannulation using the infraclavicular axillary vein. Anesthesiology 1990;72:55-58.
44. Nickalls RW. A new percutaneous infraclavicular approach to the axillary vein. Anaesthesia 1987;42:151-154.
45. Turba UC, Uflacker R, Hannegan C, Selby JB. Anatomic relationship of the internal jugular vein and the common carotid artery applied to percutaneous transjugular procedures. Cardiovasc Intervent Radiol 2005;28:303-306.
46. Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, et al. Special articles: guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society Of Cardiovascular Anesthesiologists. Anesth Analg 2012;114:46-72.
47. Alderson PJ, Burrows FA, Stemp LI, Holtby HM. Use of ultrasound to evaluate internal jugular vein anatomy and to facilitate central venous cannulation in paediatric patients. Br J Anaesth 1993; 70:145-148.
48. Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: impact on central venous access. Crit Care Med 1991;19:1516-1519.
49. Troianos CA, Kuwik RJ, Pasqual JR, Lim AJ, Odasso DP. Internal jugular vein and carotid artery anatomic relation as determined by ultrasonography. Anesthesiology 1996;85:43-48.
50. Aponte H, Acosta S, Rigamonti D, Sylvia B, Austin P, Samolitis T. The use of ultrasound for placement of intravenous catheters. AANA J 2007;75:212-216.
The publisher (Sociedad Colombiana de Anestesiología y Reanimación S.C.A.R.E.) retains copyright for the published articles.
Creative Commons License
Articles published by Colombian Journal of Anesthesiology are licensed under the Creative Commons 4.0 license: Attribution-NonCommercial-NoDerivs: CC BY-NC-ND.