What do Cochrane systematic reviews say about ultrasound-guided vascular access?

Abstract

BACKGROUND: Ultrasonography is currently used in investigating many vascular diseases, especially for guiding vascular access. OBJECTIVE: The objective here was to summarize the evidence from Cochrane systematic reviews (SRs) on the effects of ultrasound-guided vascular access as an intervention approach. DESIGN AND SETTING: Review of SRs, conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo. METHODS: A broad search was conducted in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed the effects of ultrasound guidance as a therapeutic approach towards performing any vascular access. The key characteristics and results of all the reviews included were summarized and discussed. RESULTS: Three SRs on venous access at all ages and one review on arterial access in pediatric participants were included. There was low to moderate certainty of evidence that ultrasound increased the success rate from the first puncture and the overall success rate of the procedure; and reduced the total rate of perioperative and postoperative adverse events, number of punctures, time needed to achieve success and rate of failure to place catheters. CONCLUSION: Evidence of low to moderate quality showed that ultrasound-guided vascular access seems to reduce the total rate of perioperative and postoperative complications/adverse effects, number of punctures, time needed to achieve success and rate of failure to perform venous catheterization in adults and arterial punctures in children. There is a lack of information regarding ultrasound-guided arterial puncture in adults. Further studies are still imperative for reaching solid conclusions, especially regarding arterial ultrasound-guided access.

“Passive or interactive virtual reality? The effectiveness for pain and anxiety reduction in pediatric patients”

“…This aspect also conditions pain and anxiety levels experienced by pediatric patients (Ferraz-Torres et al 2021;Gerçeker et al 2018). Therefore, in order to reduce the number of punctures and the length of time, the following resources have been identified to be effective: the use of vascular access visualization devices such as infrared devices (Galván Guzmán and Chacon Yance 2019) the ultrasound-guided approach or via ultrasound (Attie et al 2019;Mayordomo-Colunga et al 2019;Oulego-Erroz et al 2021;Sallam et al 2018). However, this kind of resources are underused at times (Elkhunovich et al 2017).…”

Arterial Access—Choosing In-Plane or Out-of-Plane Imaging for Vessel Cannulation

“…In conclusion, ultrasound-guidance for arterial access and cannulation is becoming a standard of care for this type of vascular access, as it does improve success rates and decreases complications by allowing vessel cannulation under direct visualization. [1][2][3][4][5] The trial by Arora et al has focused attention on the nuances within the realm of ultrasound-guided arterial access. Different techniques within this spectrum still require different skills.…”