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Evidence summaries

Ultrasound Guidance for Placement of Central Venous Catheters

Compared to the landmark technique for placement of internal jugular and subclavian central venous catheters, ultrasound guidance significantly increases the probability of success and reduces the number of complications. Level of evidence: "A"

A systematic review 1 including 24 RCTs was abstracted in DARE. Pooled relative risk for number of failures was 0.32 (95% CI 0.18 to 0.55), for complications during placement 0.22 (95% CI 0.10 to 0.45), and for number of attempts before success 0.60 (95% CI 0.45 to 0.79), all in favour of ultrasound guidance.The mean difference in time until successful catheter placement using ultrasound guidance was 9 seconds (95% CI: -80.1 to 62.2) compared to the landmark technique.

    References

    • 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 Dec;24(12):2053-8. [PubMed] [DARE]

Primary/Secondary Keywords