Ultrasound guided central venous access

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7391.712 (Published 29 March 2003) Cite this as: BMJ 2003;326:712

Ultrasound localisation is likely to become standard practice

  1. Andrew R Bodenham (andy.bodenham@leedsth.nhs.uk), consultant in anaesthesia
  1. Leeds General Infirmary, Leeds LS1 3EX
  2. Manchester Royal Infirmary, Manchester M13 9WL

    EDITOR—Muhm in his editorial on ultrasound guided central venous access raises many valid points, prompted by recent guidelines from the National Institute for Clinical Excellence (NICE). 1 2

    The evidence for this technology is stronger than for many other medical devices in routine use—for example, pulse oximetry or capnography in anaesthesia, which lack definitive controlled studies on outcome. I question whether is it ethical for practitioners with ultrasound skills and access to devices to revert to blind techniques for controlled trials. Such trials, if measured by numbers of complications, would require operators to persist blindly in difficult cases to the point of complication, rather than give up or use ultrasonography.

    The cost of this technology is modest compared with many other medical …

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