Original research

Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation

Lawrence M Gillman^2,3 , Michael Blaivas⁵ , Jason Lord⁴ , Azzam Al-Kadi^1,3 and Andrew W Kirkpatrick^1,2,3

¹  Departments of Surgery, University of Calgary, (1403 - 29 Street NW), Calgary, (T2N 2T9), Canada

²  Department of Critical Care Medicine, University of Calgary, (1403 - 29 Street NW), Calgary, (T2N 2T9), Canada

³  Regional Trauma Services, University of Calgary, (1403 - 29 Street NW), Calgary, (T2N 2T9), Canada

⁴  Division of Emergency Medicine, University of Calgary, (1403 - 29 Street NW), Calgary, (T2N 2T9), Canada

⁵  Department of Emergency Medicine, Northside Hospital Forsyth, (1200 Northside Forsyth Drive), Cumming, (30041), USA

author email corresponding author email

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2010, 18:39doi:10.1186/1757-7241-18-39

Published:	13 July 2010

Abstract

Background

Ultrasound guidance during central line insertion has significantly reduced complications associated with this procedure and has led to it being incorporated as standard of care in many institutions. However, inadvertent arterial penetration and dilation remains a problem despite ultrasound guidance and can result in significant morbidity and even mortality. Dynamic ultrasound confirmation of guidewire position within the vein prior to dilation may help to prevent and even eliminate this feared complication.

Methods

A prospectively collected database of central line insertions for one author utilizing this novel technique was retrospectively reviewed for all incidents of arterial dilation over a period from September 2008 to January 2010.

Results

During the study period 53 central lines were inserted with no incidents of arterial dilation.

Conclusions

Ultrasound confirmation of guidewire position has the potential to reduce or eliminate the morbidity and mortality of arterial dilation during central line placement.