International evidence-based recommendations on ultrasound-guided vascular access

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

Research output: Contribution to journalArticlepeer-review

406 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1105-1117
Number of pages13
JournalIntensive Care Medicine
Volume38
Issue number7
DOIs
StatePublished - Jul 2012

Keywords

  • Arterial cannulation
  • Central venous access
  • Critical care ultrasound
  • Evidence-based medicine
  • GRADE
  • Guideline
  • RAND
  • Ultrasound guidance
  • Vascular access

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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