Ultrasound guidance for placement of central venous catheters: A meta-analysis of the literature
Ultrasound guidance for placement of central venous catheters: A meta-analysis of the literature
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DOI：
10.1097/00003246-199612000-00020
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发表时间：
1996-12-01
影响因子：
8.8
通讯作者：
Pribble, CG
中科院分区：
文献类型：
--
作者：
Randolph, AG;Cook, DJ;Pribble, CG
目的：评价实时超声引导下常规超声或多普勒超声技术在中心静脉置管中的应用效果。数据来源：我们使用MEDLINE检索已发表和未发表的研究，检索相关主要和综述文章的引文，会议摘要，个人档案，以及与专家线人的联系。研究选择：从208项静脉和动脉导管管理的随机对照试验中，筛选出8项已发表的随机对照试验。数据提取：一式两份，我们独立地提取了关于人群、干预、结果和方法质量的数据。数据综合：与标准地标置放技术相比，超声引导显著降低颈内及锁骨下置管失败（相对风险0.32,95%置信区间0.18 ~ 0.55），降低置管过程中的并发症（相对风险0.22,95%置信区间0.10 ~ 0.45），减少多次置管尝试（相对风险0.60,95%置信区间0.45 ~ 0.79）。结论：超声引导或多普勒超声引导实时定位血管置管可提高成功率，减少颈内及锁骨下静脉置管并发症。
Objective: To evaluate the effect of real-time ultrasound guidance using a regular or Doppler ultrasound technique for placement of central Venous catheters.Data Sources: We searched for published and unpublished research using MEDLINE, citation review of relevant primary and review articles, conference abstracts, personal files, and contact with expert informants.Study Selection: From a pool of 208 randomized, controlled trials of venous and arterial catheter management, eight published randomized, controlled trials were identified.Data Extraction: In duplicate, independently, we abstracted data on the population, intervention, outcome, and methodologic quality.Data Synthesis: Ultrasound guidance significantly decreases internal jugular and subclavian catheter placement failure (relative risk 0.32; 95% confidence interval 0.18 to 0.55), decreases complications during catheter placement (relative risk 0.22; 95% confidence interval 0.10 to 0.45), and decreases the need for multiple catheter placement attempts (relative risk 0.60; 95% confidence interval 0.45 to 0.79) when compared with the standard landmark placement technique.Conclusions: When used for vessel location and catheter placement real-time, ultrasound guidance or Doppler ultrasound guidance improves success rates and decreases the complications associated with internal jugular and subclavian venous catheter placement.