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Ultrasound-Guided Central Venous Access

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The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures

Abstract

Central venous access is an essential skill for critical care providers. More than 5 million central venous catheters are inserted annually in the United States, with an overall complication rate of 15%. Use of ultrasound guidance increases success and reduces complications. The use of ultrasound guidance for central venous access has been recommended by multiple medical societies and supported by several studies in the literature. The use of ultrasound guidance for central venous catheterization has significantly increased in recent years, and it has become standard of care in current clinical practice. This chapter will review the basic principles of this technique, indications, contraindications, preparation, and procedural steps for ultrasound-guided central venous catheter (CVC) placement in the internal jugular, femoral, subclavian, and axillary veins.

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References

  1. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for internal jugular vein catheterization. Cochrane Database Syst Rev. 2015;1:CD006962.

    PubMed  Google Scholar 

  2. Brass P, Hellmich M, Kolodziej L, Schick G, Smith AF. Ultrasound guidance versus anatomical landmarks for subclavian or femoral vein catheterization. Cochrane Database Syst Rev. 2015;1:CD011447.

    PubMed  Google Scholar 

  3. Shekelle P, Dallas P. Use of real-time ultrasound guidance during central line insertion: brief update review. In: Agency For Health Research and Quality (US), editor. The New England Journal of Medicine: AHRQ; Boston, MA 2013. p. 172–7.

    Google Scholar 

  4. Milling TJ Jr, Rose J, Briggs WM, Birkhahn R, Gaeta TJ, Bove JJ, et al. 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. 2005;33(8):1764–9.

    Article  Google Scholar 

  5. Thomas S, Moore CL. The vanishing target sign: confirmation of intraluminal needle position for ultrasound guided vascular access. Acad Emerg Med. 2013;20(10):e17–8.

    Article  Google Scholar 

  6. Troianos CA, Hartman GS, Glas KE, Skubas NJ, Eberhardt RT, Walker JD, et al. Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. J Am Soc Echocardiogr. 2011;24(12):1291–318.

    Article  Google Scholar 

  7. Phelan M, Hagerty D. The oblique view: an alternative approach for ultrasound-guided central line placement. J Emerg Med. Elsevier. 2009;37(4):403–8.

    Article  Google Scholar 

  8. McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348(12):1123–33.

    Article  Google Scholar 

  9. O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):1087–99.

    Article  Google Scholar 

  10. Galloway S, Bodenham A. Ultrasound imaging of the axillary vein—anatomical basis for central venous access. Br J Anaesth. 2003;90(5):589–95.

    Article  CAS  Google Scholar 

  11. Duran-Gehring PE, Guirgis FW, McKee KC, Goggans S, Tran H, Kalynych CJ, et al. The bubble study: ultrasound confirmation of central venous catheter placement. Am J Emerg Med [Internet]. 2014.; Available from: https://doi.org/10.1016/j.ajem.2014.10.010.

    Article  Google Scholar 

  12. Rath GP, Bithal PK, Toshniwal GR, Prabhakar H, Dash HH. Saline flush test for bedside detection of misplaced subclavian vein catheter into ipsilateral internal jugular vein†. Br J Anaesth. 2009;102(4):499–502.

    Article  CAS  Google Scholar 

  13. Nagarsheth K, Kurek S. Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan. Am Surg. 2011;77(4):480–4.

    PubMed  Google Scholar 

  14. Commission J, Others. Preventing central line--associated bloodstream infections: a global challenge, a global perspective. Oak Brook: Joint Commission Resources; 2012.

    Google Scholar 

  15. Wu S-Y, Ling Q, Cao L-H, Wang J, Xu M-X, Zeng W-A. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013;118(2):361–75.

    Article  Google Scholar 

  16. Augoustides JG, Horak J, Ochroch AE, Vernick WJ, Gambone AJ, Weiner J, et al. A randomized controlled clinical trial of real-time needle-guided ultrasound for internal jugular venous cannulation in a large university anesthesia department. J Cardiothorac Vasc Anesth. 2005;19(3):310–5.

    Article  Google Scholar 

  17. Kilbourne MJ, Bochicchio GV, Scalea T, Xiao Y. Avoiding common technical errors in subclavian central venous catheter placement. J Am Coll Surg. 2009;208(1):104–9.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Azeem Tajani, Arthur Au & J. Matthew Fields

Authors
  1. Azeem Tajani
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  2. Arthur Au
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  3. J. Matthew Fields
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Editor information

Editors and Affiliations

  1. Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA

    Srikar Adhikari

  2. Department of Medicine, University of South Carolina, Columbia, SC, USA

    Michael Blaivas

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Tajani, A., Au, A., Fields, J.M. (2020). Ultrasound-Guided Central Venous Access. In: Adhikari, S., Blaivas, M. (eds) The Ultimate Guide to Point-of-Care Ultrasound-Guided Procedures . Springer, Cham. https://doi.org/10.1007/978-3-030-28267-7_6

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  • DOI: https://doi.org/10.1007/978-3-030-28267-7_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-28265-3

  • Online ISBN: 978-3-030-28267-7

  • eBook Packages: MedicineMedicine (R0)

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