• Am J Emerg Med · May 2016

    Meta Analysis Comparative Study

    Effects of long axis in-plane vs short axis out-of-plane techniques during ultrasound-guided vascular access: preliminary evidence.

    • Yan-Bing Gao, Jun-Hong Yan, Jian-Min Ma, Xiao-Na Liu, Jing-Yun Dong, Fang Sun, Li-Wei Tang, and Jie Li.
    • Department of Ultrasonography, Qilu Hospital, Shandong University, Jinan, 250000, Shandong, China; Department of Ultrasonography, Affiliated Hospital of Binzhou Medical University, Binzhou, 256603, China.
    • Am J Emerg Med. 2016 May 1; 34 (5): 778-83.

    BackgroundCurrently, whether long-axis in-plane (LA-IP) is superior to short-axis out-of-plane (SA-OOP) during ultrasound-guided vascular access remains inconclusive. We, therefore, conducted a meta-analysis of randomized controlled trials to compare the effects of LA-IP vs SA-OOP techniques in patients undergoing ultrasound-guided vascular access (USGVA).MethodsA computer-based literature search of PubMed, Embase, and the Cochrane Library (up to October 2015) was performed to identify randomized controlled trials that evaluated the effects of LA-IP compared with SA-OOP in patients undergoing USGVA. The primary end point was the first-pass success rate. Secondary end points included mean time to success, mean attempts to success, and incidence of the complication of hematoma. Weighted mean differences (WMDs) and relative risks (RRs) with 95% confidence intervals (CIs) were calculated by random-effects model.ResultsFive eligible studies with a total of 470 patients satisfied the inclusion criteria. There was no significant difference for the first-pass success rate (RR, 1.06; 95% CI, 0.91-1.23; P = .44), mean time to success (WMD, 4.78seconds; 95% CI, -4.43 to 13.99; P = .31), mean attempts to success (WMD, 0.06 times; 95% CI, -0.23 to 0.35; P = .69), and incidence of the complication of hematoma (RR, 2.86; 95% CI, 0.32-25.42; P = .35) between the LA-IP and SA-OOP groups.ConclusionsThere is insufficient evidence to definitively choose either LA-IP or SA-OOP in patients undergoing USGVA. Further robustly well-designed trials are warranted to investigate the appropriate technique in patients receiving USGVA.Copyright © 2016 Elsevier Inc. All rights reserved.

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