title: Ultrasound-guided central venous catheter placement increases success rates in pediatric patients: a meta-analysis.
abstract: Real-time ultrasound (US) guidance for central venous catheter (CVC) insertion has been shown to increase cannulation success rates and reduce complications in adults. Literature regarding US-guided CVC placement in children remains limited and conflicting. This meta-analysis examines the efficacy and safety of US-guided CVC placement among pediatric patients.
  
  
  
  A comprehensive literature search of all published randomized control trials (RCTs) comparing the use of real-time US-guided CVC insertion with anatomic landmark (LM)-guided CVC insertion in pediatric patients <18 y of age was conducted. Outcomes analyzed were cannulation success rate, number of attempts required, incidence of accidental arterial puncture, and time to cannulation.
  
  
  
  Eight RCTs involving 760 patients were analyzed. US-guided CVC insertion significantly increased success rates by 31.8% and decreased the mean number of attempts required. A trend toward a decrease in the risk of accidental arterial puncture with the use of US-guided CVC insertion was also observed. US-guided CVC insertion was not associated with a significant difference in time required for CVC placement.
  
  
  
  US-guided CVC placement is associated with significantly higher success rates and decreased mean number of attempts required for cannulation. US-guided CVC insertion improves success rates, and should be utilized in pediatric patients.
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, Livingston, New Jersey.|Saint George's University School of Medicine, True Blue, Grenada.
authors.forename: Christine S M
authors.initials: CS
authors.lastname: Lau
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, Livingston, New Jersey.|Saint George's University School of Medicine, True Blue, Grenada.|Department of Surgery, New Jersey Medical School, Rutgers University, Newark, New Jersey.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Chamberlain
mesh_terms: D000293:Adolescent; D002405:Catheterization, Central Venous / Q000379:methods*; D062905:Central Venous Catheters; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010372:Pediatrics / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D014463:Ultrasonography / Q000379:methods*