Top

Published in:

01-07-2012 | Conference Reports and Expert Panel

International evidence-based recommendations on ultrasound-guided vascular access

Authors: Massimo Lamperti, Andrew R. Bodenham, Mauro Pittiruti, Michael Blaivas, John G. Augoustides, Mahmoud Elbarbary, Thierry Pirotte, Dimitrios Karakitsos, Jack LeDonne, Stephanie Doniger, Giancarlo Scoppettuolo, David Feller-Kopman, Wolfram Schummer, Roberto Biffi, Eric Desruennes, Lawrence A. Melniker, Susan T. Verghese

Published in: Intensive Care Medicine | Issue 7/2012

Abstract

Purpose

To provide clinicians with an evidence-based overview of all topics related to ultrasound vascular access.

Methods

An international evidence-based consensus provided definitions and recommendations. Medical literature on ultrasound vascular access was reviewed from January 1985 to October 2010. The GRADE and the GRADE-RAND methods were utilised to develop recommendations.

Results

The recommendations following the conference suggest the advantage of 2D vascular screening prior to cannulation and that real-time ultrasound needle guidance with an in-plane/long-axis technique optimises the probability of needle placement. Ultrasound guidance can be used not only for central venous cannulation but also in peripheral and arterial cannulation. Ultrasound can be used in order to check for immediate and life-threatening complications as well as the catheter’s tip position. Educational courses and training are required to achieve competence and minimal skills when cannulation is performed with ultrasound guidance. A recommendation to create an ultrasound curriculum on vascular access is proposed. This technique allows the reduction of infectious and mechanical complications.

Conclusions

These definitions and recommendations based on a critical evidence review and expert consensus are proposed to assist clinicians in ultrasound-guided vascular access and as a reference for future clinical research.

Available only for authorised users

McGee DC, Gould MK (2003) Preventing complications of central venous catheterization. N Engl J Med 348:1123–1133PubMedCrossRef

Oliver W, Nuttall G, Beynen F (1997) The incidence of artery puncture with central venous cannulation using a modified technique for detection and prevention of arterial cannulation. J Cardiothoac Vasc Anesth 11:851–855CrossRef

Randolph A, Cook D, Gonzales C, Pribble C (1996) Ultrasound guidance for placament of central venous catheters: a meta-analysis of the literature. Crit Care Med 24:2053–2058PubMedCrossRef

Schummer W, Schummer C, Tuppatsch H, Fuchs J (2006) Ultrasound-guided central venous cannulation: is there a difference between Doppler and B-mode ultrasound? J Clin Anesth 18:167–172PubMedCrossRef

Verghese S, McGill W, Patel R, Sell J, Midgley F, Ruttimann R (2000) Comparison of three techniques for internal jugular vein cannulation in infants. Paed Anaesth 10:505–511CrossRef

Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C, Thomas S (2003) Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ 327:361PubMedCrossRef

Keenan SP (2002) Use of ultrasound to place central lines. J Crit Care 17:126–137PubMedCrossRef

Leung J, Duffy M, Finckh A (2006) Real-time ultrasonographically-guided internal jugular vein catheterization in the emergency department increases success rates and reduces complications: a randomized, prospective study. AnnEmMed 48:540–547

Karakitsos D, Labropoulos N, De Groot E, Patrianakos AP, Kouraklis G, Poularas J (2006) Real-time ultrasound-guided catheterisation of the internal jugular vein: a prospective comparison with the landmark technique in critical care patients. Crit Care 10:R162PubMedCrossRef

10.

Augoustides J, Horak J, Ochroch A (2005) A randomized controller clinical trial of real-time needle-guided ultrasound for internal jugular venous cannulation in a large university anesthesia department. J Cardiothorac Vasc Anesth 19:310–315PubMedCrossRef

11.

Troianos C, Jobes D, Ellison N (1991) Ultrasound-guided cannulation of the internal jugular vein. A prospective, randomized study. Anesth Analg 72:823–826PubMedCrossRef

12.

Mallory D, McGee W, Shawker T (1990) Ultrasound guidance improves the success rate of internal jugular vein cannulation. A prospective, randomized trial. Chest 98:157–160PubMedCrossRef

13.

Rothschild JM, The AHRQ Committee (2001) Making health care safer a critical analysis of patient safety practices. Evidence report/technology assessment: number 43 AHRQ. www.ahrq.gov/clinic/ptsafety/summary.htm. Accessed 15 Dec 2011

14.

National Institute for Clinical Excellence (2002) Guidance on the use of ultrasound locating devices for placing central venous catheters. National Institute for Clinical Excellence, London. www.nice.org.uk. Accessed 15 Dec 2011

15.

Pittiruti M, Hamilton H, Biffi R, MacFie J, Pertkiewicz M (2009) ESPEN guidelines on parenteral nutrition: central venous catheters (access, care, diagnosis and therapy of complications). Clinical Nutrition 28:365–377PubMedCrossRef

16.

Troianos C, Hartman G, Glas K, Skubas N, Eberhart R, Walker J, Reeves S (2011) Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr 24:1291–1318PubMedCrossRef

17.

Guyatt M, Oxman AD, Shunemann HJ, Tugwell P, Knotterus A (2011) GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol 64:380–382PubMedCrossRef

18.

Fitch K, Bernstein SJ, Aguilar MD, Burnand B, LaCalle JR, Lazaro P, van het Loo M, McDonnell J, Vader JP, Kahan JP (2001) The RAND/UCLA appropriateness method user’s manual. RAND Corporation, Arlington

19.

Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, Luketich JD, Panacek EA, Sahn SA (2001) Management of spontaneous pneumothorax: an American College of Chest Physician Delphi consensus statement. Chest 119:590–602PubMedCrossRef

20.

Maecken T, Grau T (2007) Ultrasound imaging in vascular access. Crit Care Med 35:S178–S185PubMedCrossRef

21.

Kumar A, Chuan A (2009) Ultrasound guided vascular access: efficacy and safety. Best Pract Res Clin Anesthes 23:299–311CrossRef

22.

Chapman G, Johnson D, Bodenham A (2006) Visualization of needle position using ultrasonography. Anaesthesia 61:148–158PubMedCrossRef

23.

Ortega R, Song M, Hansen C, Barash P (2010) Ultrasound-guided internal jugular vein cannulation. NEJM 362:e57PubMedCrossRef

24.

French J, Raine-Fenning N, Hardman J, Bedforth N (2008) Pitfalls of ultrasound guided vascular access: the use of three/four dimensional ultrasound. Anaesthesia 63:806–813PubMedCrossRef

25.

Hopkins R, Bradley M (2001) In vitro visualization of biopsy needles with ultrasound: a comparative study of standard and echogenic needles using an ultrasound phantom. Clinical Rad 56:499–502CrossRef

26.

Phelan M, Hagerty D (2009) The oblique view: an alternative approach for ultrasound-guided central line placement. J Emerg Med 37:403–408PubMedCrossRef

27.

Venkatesan K (2010) Echo-enhanced needles for short-axis ultrasound-guided vascular access. Int J Emerg Med 10:205CrossRef

28.

Reynolds N, McCulloch A, Pennington C (2001) Assessment of distal tip position of long-term central venous feeding catheters using transesophageal echocardiology. J Parenter Enteral Nutr 25:39–41CrossRef

29.

Hsu JH, Wang CK, Chu KS, Cheng KI, Chuang HY, Jaw TS, Wu JR (2006) Comparison of radiographic landmarks and the echocardiographic SVC/RA junction in the positioning of long-term central venous catheters. Acta Anaesth Scand 50:731–735PubMedCrossRef

30.

Leyvi G, Taylor D, Reith E, Wasnick J (2005) Utility of ultrasound-guided central venous cannulation in pediatric surgical patients: a clinical series. Ped Anesth 15:953–958CrossRef

31.

Verghese S, McGill W, Patel R, Sell J, Midgley F, Ruttimann U (1999) Ultrasound-guided internal jugular venous cannulation in infants. Anesthesiology 91:71–77PubMedCrossRef

32.

Lamperti M, Caldiroli D, Cortellazzi P, Vailati D, Pedicelli A, Tosi F, Piastra M, Pietrini D (2008) Safety and efficacy of ultrasound assistance during internal jugular vein cannulation in neurosurgical infants. Intensive Care Med 34:2100–2105PubMedCrossRef

33.

Hosokawa K, Shime N, Kato Y, Hashimoto S (2007) A randomized trial of ultrasound image-based skin surface marking versus real-time ultrasound-guided internal jugular vein catheterization in infants. Anesthesiology 107:720–724PubMedCrossRef

34.

Mallory D, McGee W, Shawker T, Brennen M, Bailey K, Evans R, Parker M, Farmer J, Parrillo J (1990) Ultrasound guidance improves the success rate of internal jugular vein cannulation. a prospective, randomized trial. Chest 98:157–160PubMedCrossRef

35.

Denys B, Uretsky B, Reddy P (1993) Ultrasound-assisted cannulation of the internal jugular vein a prospective comparison to the external landmark-guided technique. Circulation 87:1557–1562PubMedCrossRef

36.

Serafimidis K, Sakorafas G, Konstantoudakis G, Petropoulou K, Giannopoulos G, Danias N, Peros G, Safioleas M (2009) Ultrasound-guided catheterization of the internal jugular vein in oncologic patients; comparison with the classical anatomic landmark technique: a prospective study. Int J Surg 7:526–528PubMedCrossRef

37.

Blaivas M, Adhikari S (2009) An unseen danger: frequency of posterior vessel wall penetration by needles during attempts to place internal jugular vein central catheters using ultrasound guidance. Crit Care Med 37:2345–2349PubMedCrossRef

38.

Paul-Andrè C, Kendall J (2004) Ultrasound guidance for vascular access. Emerg Med Clin N Am 22:749–773CrossRef

39.

Blaivas M, Brannam L, Fernandez E (2003) Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model. Acad Emerg Med 10:1307–1311PubMedCrossRef

40.

Breschan C, Platzer M, Jost R, Stettner H, Beyer AS, Feigl G, Likar R (2011) Consecutive, prospective case series of a new method for ultrasound-guided supraclavicular approach to the brachiocephalic vein in children. Br J Anaesth 106:732–737PubMedCrossRef

41.

Fragou M, Gravvanis A, Dimitriou V, Papalois A, Kouraklis G, Karabinis A, Saranteas T, Poularas J, Papanikolaou J, Davlouros P, Labropoulos N, Karakitsos D (2011) Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study. Crit Care Med 39:1607–1612PubMedCrossRef

42.

Bodenham A (2006) Editorial II: ultrasound imaging by anaesthetists: training and accreditation issues. Br J Anaesth 96:414–417PubMedCrossRef

43.

Dowling M, Jlala H, Hardman J, Bedforth N (2011) Real-time three-dimensional ultrasound-guided central venous catheter placament. Anesth Analg 112:378–381PubMedCrossRef

44.

Schummer W, Schummer C, Tuppatsch H, Fuchs J, Bloos F, Huttemann E (2005) Ultrasound-guided central venous cannulation: is there a difference between Doppler and B-mode ultrasound? J Clin Anesth 18:167–172CrossRef

45.

Stone M, Moon C, Sutijono D, Blaivas M (2010) Needle tip visualization during ultrasound-guided vascular access: short-axis vs long-axis approach. Am J Emerg Med 28:343–347PubMedCrossRef

46.

Milling T, Holden C, Melniker L, Briggs W, Birkhahn R, Gaeta T (2006) Randomized controller trial of single-operator vs. two-operator ultrasound guidance for internal jugular central venous cannulation. Acad Emerg Med 13:245–247PubMedCrossRef

47.

Mallinson C, Bennet J, Hodgson P, Petros A (1999) Position of the internal jugular vein in children. A study of the anatomy using ultrasonography. Paed Anaesth 9:111–114CrossRef

48.

Sigaut S, Skhiri A, Stany I, Golmar J, Nivoche Y, Constant I, Murat I, Dahmani S (2009) Ultrasound guided internal jugular vein access in children and infant: a meta-analysis of published studies. Ped Anaesth 19:1199–1206CrossRef

49.

Detaille T, Pirotte T, Veyckemans F (2010) Vascular access in the neonate. Best Pract Res Clin Anaesthesiol 24:403–418PubMedCrossRef

50.

Breschan C, Platzer M, Jost R, Stettner H, Likar R (2010) Size of internal jugular versus subclavian vein in small infants: an observational, anatomical evaluation with ultrasound. Br J Anaesth 105:179–184PubMedCrossRef

51.

Pirotte T, Veyckemans F (2007) Ultrasound-guided subclavian vein cannulation in infants and children: a novel approach. Br J Anesth 98:509–514CrossRef

52.

Rhondali O, Attof R, Combet S (2011) Ultrasound-guided subclavian vein cannulation in infants: supraclavicular approach. Paediatr Anaesth 21:1136–1141PubMedCrossRef

53.

O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, Lipsett PA, Masur H, Mermel LA, Pearson ML, Raad II, Randolph AG, Rupp ME, Saint S, Healthcare Infection Control Practices Advisory Committee (2011) Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control 39:S1–34PubMedCrossRef

54.

Iwashima S, Ishikawa T, Ohzeki T (2008) Ultrasound-guided versus landmark-guided femoral vein access in pediatric cardiac catheterization. Pediatr Cardiol 29:339–342PubMedCrossRef

55.

Hopkins J, Warkentine F, Gracely E, Kim I (2009) The anatomic relationship between the common femoral artery and common femoral vein in frog leg position versus straight leg position in pediatric patients. Acad Emerg Med 16:579–584PubMedCrossRef

56.

Doniger S, Ishimine P, Fox J, Kanegaye J (2009) Randomized controlled trial of ultrasound-guided peripheral intravenous catheter placement versus traditional techniques in difficult-access pediatric patients. Pediatr Emer Care 25:154–159CrossRef

57.

Ganesh A, Kaye R, Cahill A, Stern W, Pachikara R, Gallagher P, Watcha M (2009) Evaluation of ultrasound-guide radial artery cannulation in children. Pediatric Crit Care Med 10:45–48CrossRef

58.

Sayin M, Mercan A, Koner O, Ture H, Celebi S, Sozubir S, Aykac B (2008) Internal jugular vein diameter in pediatric patients: are the J-shaped guidewire diameters bigger than internal jugular vein? An evaluation with ultrasound. Ped Anesth 18:745–751CrossRef

59.

Bishop L, Dougherty L, Bodenham A, Mansi J, Crowe P, Shannon M, Treleaven J (2007) Guidelines on the insertion and management of central venous access devices in adults. Int J Lab Hem 29:261–278CrossRef

60.

Milling T, Rose J, Briggs W, Birkhahn R, Gaeta T, Bove J, Melniker L (2005) Randomized, controlled clinical trial of point-of-care limited ultrasonography assistance of central venous cannulation: The Third Sonography Outcomes Assessment Program (SOAP-3) Trial. Crit Care Med 33:1764–1769PubMedCrossRef

61.

62.

Debordeau P, Chahml D, LeGal G, Kriegel I, Desruennes E, Douard M, Elalamy I, Meyer G, Mismetti P, Pavic M, Scrobohacl M, Levesque H, Renaudln J, Farge D (2009) 2008 SOR guidelines for the prevention and treatment of thrombosis associated with central venous catheters in patients with cancer: report from the working group. Ann Onc 20:1459–1471CrossRef

63.

Nichols I, Humprey J (2008) The efficacy of upper arm placement of peripherally inserted central catheters using bedside ultrasound and microintroducer technique. J Inf Nursing 31:165–176CrossRef

64.

Shiloh A, Savel E, Paulin L (2011) Ultrasound-guided catheterization of the radial artery: a systematic review and meta-analysis of randomized controller trials. Chest 139:524–529PubMedCrossRef

65.

Lichtenstein D, Menu Y (1995) A bedside ultrasound sign ruling out pneumothorax in the critically ill. Chest 5:1345–1348CrossRef

66.

Vezzani A, Brusasco C, Palermo S, Launo C, Mergoni M, Corradi F (2010) Ultrasound localization of central vein catheter and detection of postprocedural pneumothorax: an alternative to chest radiography. Crit Care Med 38:533–538PubMedCrossRef

67.

Calvert N, Hind D, McWilliams R (2004) Ultrasound for central venous cannulation: economic evaluation of cost-effectiveness. Anaesthesia 59:1116–1120PubMedCrossRef

68.

Denys BG, Uretsky BF (1991) Anatomical variations of internal jugular vein location: impact on central venous access. Crit Care Med 19:1516–1519PubMedCrossRef

69.

Lee AC, Thompson C, Frank J, Beecker J, Yeung M, Woo MY, Cardinal P (2009) Effectiveness of a novel training program for emergency medicine residents in ultrasound-guided insertion of central venous catheters. CJEM 11:343–348PubMed

70.

Barsuk JH, McGaghie WC, Cohen ER (2009) Simulation-based mastery learning program reduces complications during central venous catheter insertion in a medical intensive care unit. Crit Care Med 37:2697–2701PubMedCrossRef

71.

Evans LV, Morse JL, Hamann CJ (2009) The development of an independent rater system to assess residents’ competence in invasive procedures. Acad Med 84:1135–1143PubMedCrossRef

72.

Raad II, Hohn DC, Gilbreath BJ, Suleiman N, Hill LA, Bruso PA, Marts K, Mansfiled PF, Bodey GP (1994) Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 15:231–238PubMedCrossRef

73.

Institute for Healthcare Improvement (IHI) (2005) What is a bundle? http://www.ihi.org/knowledge/Pages/ImprovementStories/WhatIsaBundle.aspx. Accessed Nov 8 2011

74.

Pronovost PJ, Needham D, Berhenholtz S, Sinopoli D, Haiatao C, Cosgrove S, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeshel C (2006) An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 355:2725–2732PubMedCrossRef

75.

Farahmand S, Farnia M, Shahriaran S, Khashayar P (2011) The accuracy of limited B-mode compression technique in diagnosing deep vein thrombosis in lower extremities. Am J Emerg Med 29:687–690PubMedCrossRef

76.

Nifong TP, Mc Devitt TJ (2011) The effect of catheter to vein ratio on blood flow rates in a simulated model of peripherally inserted central venous catheter. Chest 140:48–53PubMedCrossRef

Title: International evidence-based recommendations on ultrasound-guided vascular access
Authors: Massimo Lamperti
Andrew R. Bodenham
Mauro Pittiruti
Michael Blaivas
John G. Augoustides
Mahmoud Elbarbary
Thierry Pirotte
Dimitrios Karakitsos
Jack LeDonne
Stephanie Doniger
Giancarlo Scoppettuolo
David Feller-Kopman
Wolfram Schummer
Roberto Biffi
Eric Desruennes
Lawrence A. Melniker
Susan T. Verghese
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2012
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-012-2597-x

At a glance: The STEP trials

Springer Medicine

International evidence-based recommendations on ultrasound-guided vascular access

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2012

Religion and end-of-life decisions in critical care: where the word meets deed

Increased nonbeneficial care in patients spending their birthday in the ICU

Hyperbaric oxygen therapy in necrotising soft tissue infections: a study of patients in the United States Nationwide Inpatient Sample

Azithromycin to prevent Pseudomonas aeruginosa ventilator-associated pneumonia by inhibition of quorum sensing: a randomized controlled trial

Random errors in insulin infusion concentrations

Prospective validation of the vasoactive-inotropic score and correlation to short-term outcomes in neonates and infants after cardiothoracic surgery