title: Can you justify not using ultrasound guidance for central venous access?
abstract: Karakitsos and coworkers, in this journal, reported further compelling evidence on the value of ultrasound in guiding internal jugular vein catheterization. In a large, prospective, randomized study of 900 patients, comparisons were made between patients in whom the procedure was performed using landmark-based techniques and those assigned to ultrasound guidance. The key benefits from use of ultrasound included reduction in needle puncture time, increased overall success rate (100% versus 94%), reduction in carotid puncture (1% versus 11%), reduction in carotid haematoma (0.4% versus 8.4%), reduction in haemothorax (0% versus 1.7%), decreased pneumothorax (0% versus 2.4%) and reduction in catheter-related infection (10% versus 16%). The implications of these findings are discussed, and a compelling case for routine use of ultrasound to guide central venous access is made.
authors.affiliation: Department of Anaesthesia, Leeds General Infirmary, Leeds, LS1 3EX, UK. Andy.Bodenham@leedsth.nhs.uk
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Bodenham
mesh_terms: D002405:Catheterization, Central Venous / Q000379:methods*; D006801:Humans; D007601:Jugular Veins; D018084:Ultrasonography, Interventional