RT Journal
A1 Fry WR, Clagett GC, O'Rourke P
T1 ULtrasound-guided central venous access
JF Archives of Surgery
JO Archives of Surgery
YR 1999
FD July 1
VO 134
IS 7
SP 738
OP 741
DO 10.1001/archsurg.134.7.738
UL http://dx.doi.org/10.1001/archsurg.134.7.738
AB Hypothesis 
    Real-time ultrasound guidance should increase the success rate and lower the complication rate of central venous access in patients with relative contraindications to having the procedure performed.Design 
    Prospective case series.Setting 
    A community-based tertiary care hospital.Patients 
    Fifty-two patients were studied. Relative risks to central venous catheter insertion included (1) thrombosis or stenosis of central veins, (2) inherent or acquired anticoagulation abnormalities, (3) inability to assume a supine position, (4) hypovolemia, (5) obesity or altered anatomy, and (6) severe respiratory compromise.Interventions 
    Real-time ultrasound evaluation of the proposed vein to be cannulated, followed by real-time percutaneous central vein access.Main Outcome Measures 
    Successful cannulation of a central vein.Results 
    All attempts at central vein cannulation were successful. No bleeding complications occurred. One pneumothorax occurred in an obese patient.Conclusions 
    Ultrasound-guided central venous access is a helpful technique to gain venous access in difficult cases. Surgeons who perform central venous access procedures should become acquainted with the techniques involved. The techniques should be incorporated into currently developing ultrasound instruction courses for surgeons.