Insertion of temporary dialysis catheters with the aid of real-time ultrasound

Abstract EN

Central venous catheters are widely used for both temporary and long-term angioaccess for hemodialysis.

Insertion of these catheters is commonly performed using anatomic landmarks to guide vessel cannulation.

Using traditional landmark-techniques, internal jugular venous catheter insertion is successful 82-88 % of the time, with successful first-attempt cannulation of only 35-38 %.

Variations in anatomic relationships between the vein and surrounding structures may contribute to difficulty in venous cannulation using these traditional techniques.

Real-time ultrasound guidance permits direct visualization of the target vein during catheter placement and is associated with increased successful cannulation (78-83 % on first pass ; 97-100 % overall), a decreased number of attempts and a decreased complication rate.

For this reason, we believe that real-time ultrasound-guided catheter insertion is superior to the traditional anatomic-landmark techniques and is emerging as the new standard of care.