The article by Fragou et al (1), in this month's Critical Care Medicine, provides compelling evidence that the routine use of ultrasound guidance increases the safety of central venous access by the subclavian route. In this cohort of critical care patients, cannulation was achieved in 100% of patients in the ultrasound group as compared with 87.5% in the landmark arm. Access time and the number of attempts were reduced in the ultrasound group as were arterial puncture, hematoma, hemothorax, pneumothorax, and brachial plexus injury, Catheter misplacements did not differ between groups.
展开▼
