Ultrasound-guided central venous cannulation

The placement of central venous catheters (CVC) is one of the most frequent procedures in the intensive care unit; however, it is not free of mechanical complications. Before the advent of bi-dimensional echography, physicians used to place CVC according to the landmark technique. This technique was based on anatomical observations describing the most frequent position of the vessels. However, the position may vary and thus failure and mechanical complications (sometimes severe) occur. With bi-dimensional echography, physicians can see what they used to palpate. Interestingly, ultrasounds have demonstrated their ability to improve the success rate, number of punctures, duration of the procedure, number of complications, comfort, and cost. Though physicians should still be able to use the landmarks, the echoguidance is now the technique referent.