Conclusion
US guidance can improve patient safety and procedural quality during CVC placement in the IJV, FV, and SV. Based on evidence from clinical studies, several guidelines of medical societies strongly recommend the use of US for CVC placement in the IJV. Data from survey studies show that there is still a gap between the existing evidence and guidelines and the use of US in clinical practice. We recommend a six-step systematic approach for US-guided central venous access. To achieve the best skill level for CVC placement the knowledge from anatomic landmark techniques and the knowledge from US-guided CVC placement need to be combined and integrated.
Abbreviations
CVC: Central venous catheter; FV: Femoral vein; IJV: Internal jugular vein; SV: Subclavian vein; US: Ultrasound
Acknowledgements
The authors thank Oliver Diener, Maximilian Leistenschneider, and Elisabeth von Heckel for their support in obtaining the US images and the photographs illustrating the procedure for US-guided CVC placement.
Funding
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Consent for publication
Written informed consent for publication of their ultrasound images was obtained from the patients and volunteers. A copy of the consent form is available for review by the Editor of this journal.
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Crit Care. 2017;21(225) © 2017 BioMed Central, Ltd.
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