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Does ultrasound-guided central line insertion reduce complications and time to placement in elective patients undergoing cardiac surgery

Department of Cardiothoracic Surgery, Freeman Hospital, Freeman Road, Newcastle-upon-Tyne NE7 7DN, UK

^* Corresponding authors. Tel./fax: +44-780-154-8122
anthony.espinet{at}nuth.northy.nhs.uk

joeldunning{at}doctors.org.uk

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether ultrasound probe central line placement reduced complications and time to placement in patients undergoing coronary artery bypass grafting surgery. Altogether, 193 papers were found from Medline using the reported search of which 6 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses and comments were tabulated. We conclude that in patients with a potentially difficult central line insertion, the ultrasound technique reduces complications and time to insertion. However, in those patients where no difficulty is predicted, there is no evidence that the ultrasound technique confers any advantage.

Key Words: Evidence-based medicine; Central venous catheterisation; Review; Cardiac surgery; Ultrasonography

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