Proposal for the development of German central venous access guidelines
Abstract:
The American Society of Anesthesiologists released practice guidelines for central venous access in 2020, and the entire world literature was examined for evidence on how to perform the entire process with best practice and minimal risk and harm to the patient. These guidelines may serve as a gold standard for individual procedural steps, allowing practitioners and hospital departments to critically question the own standard and improve upon them. We interpreted the guidelines for individual procedural steps on how to improve success of catheterization, minimize risks or adverse effects, enhance the management of accidental arterial punctures, adhere to evidence-based practices, and generally reduce the trauma of puncturing. In our opinion, the most needed recommendation for central venous access is to utilize ultrasound guidance, a practice that many international societies have already incorporated into their published national guidelines. In our view, it is time to implement a national guideline for central venous access using ultrasound in Germany. Doing so may improve success rates in the first attempt, reduce procedural time, decrease the number of needle insertions per patient, and lower the rate of arterial punctures. This approach represents best practice from ethical, insurance, civil rights, and patient security perspectives, and is supported by relevant societies.
Reference:
Armbruster W, Eichholz R, Notheisen T. Amerikanische Praxis-Leitlinie für den zentralen Venenzugang aus dem Jahr 2020 [Practice Guidelines for Central Venous Access 2020 – Time for German Guidelines]. Anasthesiol Intensivmed Notfallmed Schmerzther. 2024 Apr;59(4):252-262. German. doi: 10.1055/a-1690-5730. Epub 2024 Apr 29. PMID: 38684160.