title: International evidence-based recommendations on ultrasound-guided vascular access.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Neuroanesthesia, Neurological Institute Besta, Via Celoria, 11, 20136, Milan, Italy. doclampmd@gmail.com
authors.forename: Massimo
authors.initials: M
authors.lastname: Lamperti
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Bodenham
authors.forename: Mauro
authors.initials: M
authors.lastname: Pittiruti
authors.forename: Michael
authors.initials: M
authors.lastname: Blaivas
authors.forename: John G
authors.initials: JG
authors.lastname: Augoustides
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Elbarbary
authors.forename: Thierry
authors.initials: T
authors.lastname: Pirotte
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karakitsos
authors.forename: Jack
authors.initials: J
authors.lastname: Ledonne
authors.forename: Stephanie
authors.initials: S
authors.lastname: Doniger
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Scoppettuolo
authors.forename: David
authors.initials: D
authors.lastname: Feller-Kopman
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schummer
authors.forename: Roberto
authors.initials: R
authors.lastname: Biffi
authors.forename: Eric
authors.initials: E
authors.lastname: Desruennes
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Melniker
authors.forename: Susan T
authors.initials: ST
authors.lastname: Verghese
mesh_terms: D000328:Adult; D002405:Catheterization, Central Venous / Q000379:methods* / Q000592:standards; D002406:Catheterization, Peripheral / Q000379:methods* / Q000592:standards; D002648:Child; D003245:Consensus Statements as Topic; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006801:Humans; D007231:Infant, Newborn; D018608:Ultrasonography, Doppler / Q000379:methods* / Q000592:standards; D018084:Ultrasonography, Interventional / Q000379:methods* / Q000592:standards