Ultrasound-guided central vascular interventions, comments on the European Federation of Societies for Ultrasound in Medicine and Biology guidelines on interventional ultrasound (original) (raw)
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Ultrasound-guided peripheral venous access: Is it the standard of care
Venous access or cannulation is the most common invasive procedure being performed in the hospitals. It may appear very simple and straight forward routine, but every one of us has encountered a situation when, due to any one or multiple causes, we feel it almost impossible to gain access. It is here that ultrasound comes into play. Although original cost and lack of training have limited its acceptance for wide spread use in all departments of a hospital, the advantages offered by it, will soon overcome the obstacles and will become the standard of care as far as peripheral or central venous access is concerned. This editorial highlights the difficulties and the scope of this new tool in ER, ICU and OR.
The journal of vascular access, 2017
Centrally inserted central catheter (CICC) insertion is a commonly performed procedure that may give rise to different complications. Despite the suggestion of guidelines to use ultrasound guidance (USG) for vascular access, not all centers use it systematically. The aim of this study is to illustrate the experience with ultrasound in CICC placement at a high-volume oncological center, in a country where the landmark technique is standard. Retrospective analysis of a prospective database was performed on CICC placement under USG in the Central Venous Catheter Unit of Instituto Português de Oncologia de Lisboa Francisco Gentil, from 2012 to 2015. Three thousand five hundred and seventy-two procedures were recorded. From 2728 CICC placements, 1187 (43.5%) were done using USG. The majority of CICC placements were successful without immediate complications (96.1%). In 55 cases (4.6%), more than three attempts were necessary to puncture the vein. Pneumothorax occurred in 5 cases (0.4%) a...
US-guided peripheral vascular interventions, comments on the EFSUMB guidelines
Medical ultrasonography, 2016
Peripheral venous as well as arterial punctures have traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. This review comments on the evidence-based recommendations on ultrasound (US)-guided vascular access which have been published recently within the framework of Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for US in Medicine and Biology (EFSUMB) from a clinical practice point of view. Part 1 of the review had its focus on general aspects of US- guidance and on central venous access, whereas part 2 refers to peripheral vascular access.
The Journal of Vascular Access
Purpose: Central venous catheter insertion is a common procedure in the intensive care setting. However, complications persist despite real-time ultrasound guidance. Recent innovation in needle navigation technology using guided positioning system enables the clinician to visualize the needle’s real-time position and trajectory as it approaches the target. We hypothesized that the guided positioning system would improve performance time in central venous catheter insertion. Methods: A prospective randomized study was conducted in a single-center adult intensive care unit. In total, 100 patients were randomized into two groups. These patients underwent internal jugular vein central venous catheter cannulation with ultrasound guidance (short-axis scan, out-of-plane needling approach) in which one group adopted conventional method, while the other group was aided with the guided positioning system. Outcomes were measured by procedural efficacy (success rate, number of attempts, time to...
Ultrasound guidance for vascular access
Emergency medicine clinics of North …, 2004
1. Emerg Med Clin North Am. 2004 Aug;22(3):749-73. Ultrasound guidance for vascular access. Abboud PA, Kendall JL. Department of Emergency Medicine, Kaiser Permanente Medical Center-Oakland,280 West MacArthur Boulevard, Oakland, CA 94611, USA. ...
Ultraschall in der Medizin - European Journal of Ultrasound, 2015
This is the first of two guidelines (parts IV and V) within the framework of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on Interventional Ultrasound describing endoscopic ultrasound (EUS)guided diagnostic and therapeutic interventions. Part IV deals with the indications and clinical impact of EUS-guided sampling 1 and gives evidencebased recommendations for the safe and efficient performance of this technique based on the available evidence at the time of manuscript prepara-1 Term is explained in the addendum on terminology
British Journal of Anaesthesia, 2011
† Ultrasound-guided placement of central venous catheters is widely accepted as safe practice. † The use of a needle guide paired with the long-axis ultrasound approach facilitated puncture of the target vessel in a simulation model more effectively than similar free-hand techniques. † The needle guide used in the long-axis technique did not facilitate puncture of the target compared with free-hand techniques. Background. Short-axis ultrasound-guided placement of central venous catheters (CVCs) is widely accepted as safe practice. However, utilizing the long-axis approach could further improve safety, as it allows for better visualization of the needle as it is advanced to the target vessel. However, the long-axis approach has not widely been used due to the technical difficulty. Recently, a new needle guidance device has become available to aid in the long-axis approach. We hypothesized that the use of a needle guide paired with the long-axis approach would facilitate puncture of the target vessel in a simulation model more effectively than similar free-hand techniques. Methods. A prospective observational study of anaesthesia residents using a CVC partial-task training device was conducted. Each resident performed needle puncture of the target vessel with three different techniques, assigned in random order: short-axis free hand (S-FH), longaxis free hand (L-FH), and long-axis needle guide (NG). To prove the effectiveness of the needle guide, the fraction of time the needle tip remained in view of the ultrasound was recorded and compared. Time required for completing the task and the number of needle sticks and needle re-directions were compared. Results. Thirty-three residents participated in the study. The fraction of time the needle tip remained in view of the ultrasound was significantly higher for the residents using NG [0.90 (0.10)] compared with residents using the other techniques [L-FH: 0.36 (0.20), S-FH: 0.18 (0.10)] (P,0.001). For each resident, the use of the needle guide in the long-axis approach increased visualization by 352 (276)% compared with that of L-FH and by 1028 (1804) % compared with that of S-FH. There was no significant difference in time required to puncture the target between NG [23.7 (14.6) s] and L-FH [30.3 (36.5) s] (P¼0.21); however, both were significantly longer than S-FH [17.0 (13.3) s] (P¼0.012). The numbers of needle sticks and of needle re-directions did not differ among the groups. Conclusions. The needle guide device used in the long-axis approach improved the needle visualization compared with free-hand techniques. The needle guide used in the long-axis technique, however, did not facilitate puncture of the target vessel in this simulation model when compared with free-hand techniques.
Research Journal of Medical Sciences
Real-time ultrasound-guided Central Venous Catheterization (CVC) has been demonstrated to reduce insertion and procedure time as well as having less complications when compared to the landmark-guided technique. This technique was newly introduced to Jordan University Hospital (JUH) and the aim of this study is to report our experience in both techniques. Medical records of 203 patients who needed central venous catheterization in the JUH between May, 2016 and May, 2017 were reviewed. The ultrasound-guided group included 102 patients while the landmark-guided group included 101 patients. The duration of catheter insertion, procedure duration and complications were considered. The average number of catheterization attempts in the ultrasound-guided group was significantly less when compared with the landmark-guided group (p<0.001). Furthermore, the duration of insertion and the duration of the procedure were both significantly shorter in the ultrasound-guided group compared to the landmark group (p<0.001 for both). Carotid artery punctures and hematoma formation were also significantly less in the ultrasound-guided group compared with the landmark group (p = 0.019). The ultrasound-guided method for central venous catheterization could increase the efficiency and reduce medical complications which justifies the costs of implementing this technique.