Meta-Analysis Finds Ultrasound Guidance Superior to Landmark Technique for Central Venous Catheter Placement

Researchers performed a meta-analysis to compare real-time two-dimensional ultrasound with the anatomical landmark technique for central venous catheter placement. They identified 26 randomized, controlled studies that reported cannulation failure and adverse events; the studies included 4185 vascular access attempts of the internal jugular (20 studies), subclavian (4) and femoral veins (3).

Ultrasound guidance significantly reduced the overall risk for cannulation failure (pooled relative risk, 0.18), arterial puncture (RR, 0.25), hematoma (RR, 0.30), pneumothorax (RR, 0.21), and hemothorax (RR, 0.10). In subgroup analyses by age (<8 years and >18 years), significant risk reductions were observed only in adults. However, pediatric data were…