Intended for healthcare professionals

Rapid response to:

Paper

Ultrasonic locating devices for central venous cannulation: meta-analysis

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7411.361 (Published 14 August 2003) Cite this as: BMJ 2003;327:361

Rapid Response:

Ultrasound for central venous cannulation.

The meta-analysis provides further evidence supporting the use of
ultrasound for central venous cannulation [1]. The critical care world has
been reluctant to embrace this technology. In 2000 we sent a questionnaire
to critical care units in the UK [2]. Less than a quarter of units used
ultrasound for central venous cannulation, and of these only 11% used it
routinely. Half of the units used ultrasound sub-optimally by identifying
the internal jugular vein prior to blind cannulation rather than using
continuous real-time guidance.
In 1999, Scott [3] predicted that ‘early in the next millenium… ultrasound
guidance will be a prerequisite before and during central venous
cannulation.’ The current situation is far removed from this ideal and it
will be interesting to see if the apathy towards ultrasound guidance
changes.

REFERENCES

[1] Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley
C et al. Ultrasonic locating devices for central venous cannulation: meta
-analysis. BMJ 2003;327:361-4.

[2] Jefferson P, Ogbue MN, Hamilton K.E.StC, Ball DR. A survey of the use
of portable ultrasound for central vein cannulation on critical care units
in the UK. Anaesthesia 2002;57:365-8.

[3] Scott DHT. In the country of the blind, the one-eyed man is king. Br J
Anaesth 1999;82:820-1.

Competing interests:  
None declared

Competing interests: No competing interests

18 August 2003
Paul Jefferson
Consultant anaesthetist
David R. Ball
Dumfries and Galloway Royal Infirmary DG1 1SY