International evidence-based recommendations on ultrasound-guided vascular access

• Published in: Intensive care medicine 2012-07, Vol.38 (7), p.1105-1117
• Main Authors: Lamperti, Massimo, Bodenham, Andrew R., Pittiruti, Mauro, Blaivas, Michael, Augoustides, John G., Elbarbary, Mahmoud, Pirotte, Thierry, Karakitsos, Dimitrios, LeDonne, Jack, Doniger, Stephanie, Scoppettuolo, Giancarlo, Feller-Kopman, David, Schummer, Wolfram, Biffi, Roberto, Desruennes, Eric, Melniker, Lawrence A., Verghese, Susan T.
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthesiology; Biological and medical sciences; Blood vessels and receptors; Cannulation; Catheterization, Central Venous - methods; Catheterization, Central Venous - standards; Catheterization, Peripheral - methods; Catheterization, Peripheral - standards; Catheters; Child; Clinical medicine; Conference Reports and Expert Panel; Consensus Development Conferences as Topic; Cost-Benefit Analysis; Critical care; Critical Care Medicine; Emergency medical care; Emergency Medicine; Evidence-Based Medicine; Fundamental and applied biological sciences. Psychology; Health aspects; Hospitals; Humans; Infant, Newborn; Intensive; Intensive care; Intensive care medicine; Librarians; Medical sciences; Medicine; Medicine & Public Health; Methods; Pain Medicine; Pediatrics; Pneumology/Respiratory System; Ultrasonic imaging; Ultrasonography, Doppler - methods; Ultrasonography, Doppler - standards; Ultrasonography, Interventional - methods; Ultrasonography, Interventional - standards; Ultrasound imaging; Venous access; Vertebrates: cardiovascular system
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-012-2597-x

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.