What do Cochrane systematic reviews say about ultrasound-guided vascular access?

Autor:	Attie GA; Undergraduate Student Researcher, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Flumignan CDQ; MD, PhD. Researcher, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Silva MAM; MD. Researcher, Postgraduate Program on Interdisciplinary Surgical Science, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), and Division of Vascular and Endovascular Surgery, Hospital de Clínicas de Itajubá, Itajubá, MG, Brazil., Barros EM; Undergraduate Student Researcher, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Daolio RM; Undergraduate Student Researcher, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Guedes Neto HJ; MD, PhD. Adjunct Professor, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Baptista-Silva JCC; MD, PhD. Full Professor and Chief, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Amorim JE; MD, PhD. Adjunct Professor, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Nakano LCU; MD, PhD. Adjunct Professor, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil., Flumignan RLG; MD, PhD. Adjunct Professor, Department of Surgery, Division of Vascular and Endovascular Surgery, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2019 Aug 29; Vol. 137 (3), pp. 284-291. Date of Electronic Publication: 2019 Aug 29.
DOI:	10.1590/1516-3180.2019.0113070519
Abstrakt:	Background: Ultrasonography is currently used in investigating many vascular diseases, especially for guiding vascular access. Objective: The objective here was to summarize the evidence from Cochrane systematic reviews (SRs) on the effects of ultrasound-guided vascular access as an intervention approach. Design and Setting: Review of SRs, conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo. Methods: A broad search was conducted in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed the effects of ultrasound guidance as a therapeutic approach towards performing any vascular access. The key characteristics and results of all the reviews included were summarized and discussed. Results: Three SRs on venous access at all ages and one review on arterial access in pediatric participants were included. There was low to moderate certainty of evidence that ultrasound increased the success rate from the first puncture and the overall success rate of the procedure; and reduced the total rate of perioperative and postoperative adverse events, number of punctures, time needed to achieve success and rate of failure to place catheters. Conclusion: Evidence of low to moderate quality showed that ultrasound-guided vascular access seems to reduce the total rate of perioperative and postoperative complications/adverse effects, number of punctures, time needed to achieve success and rate of failure to perform venous catheterization in adults and arterial punctures in children. There is a lack of information regarding ultrasound-guided arterial puncture in adults. Further studies are still imperative for reaching solid conclusions, especially regarding arterial ultrasound-guided access.
Databáze:	MEDLINE
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