Recommendations
Guidelines on the use of ultrasound guidance for vascular access

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Abstract

Insertion of vascular access is a common procedure with potential for iatrogenic events, some of which can be serious. The spread of ultrasound scanners in operating rooms, intensive care units and emergency departments has made ultrasound-guided catheterisation possible. The first guidelines were published a decade ago but are not always followed in France. The French Society of Anaesthesia and Intensive Care has decided to adopt a position on this issue through its Guidelines Committee in order to propose a limited number of simple guidelines. The method used was the GRADE® method using the most recently published meta-analyses as the source of references. The level of evidence found ranged from low to high and all the positive aspects associated with ultrasound guidance, i.e. fewer traumatic complications at puncture, probably or definitely outweigh the potential adverse consequences regardless of whether an adult or child is involved and regardless of the site of insertion.

Section snippets

Steering committee

Paul Zetlaoui, Hervé Bouaziz, Sébastien Pierre.

Working group: Eric Desruennes, Nicolas Fritsch, Denis Jochum, Frédéric Lapostolle, Thierry Pirotte, Stéphane Villiers.

Document validated by the Sfar [French Society of Anaesthesia and Intensive Care] board on Friday 12 September 2014.

Question asked

To insert a central venous access via the internal jugular vein in an adult, should ultrasound-guided puncture or anatomical cutaneous landmark-based cannulation be used?

Data

The results of the meta-analysis demonstrated an 86% reduction in the rate of catheterisation failure (RR: 0.14; 95%CI: 0.09–0.23) in 13 randomised, controlled trials including 2653 patients, an 80% reduction in arterial puncture rates (RR: 0.20; 95%CI: 0.13–0.32) in 13 randomised, controlled trials including 2675 patients, a

Disclosure of interest

Nicolas Fritsch, Frédéric Lapostolle, Sébastien Pierre, Thierry Pirotte and Stéphane Villiers declare that they have no conflicts of interest concerning this article.

Hervé Bouaziz declares having received in the past payments for expert advice from the following companies: B/Braun®, Gamida®, General Electric® and Sonosite®.

Eric Desruennes declares having received in the past payments for expert advice from the following companies: B/Braun® and Perouse®.

Denis Jochum declares having received in

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