Scope: Ultrasound locating devices for placing central venous lines.

Objective: to establish the clinical and cost effectiveness of using ultrasound locating devices for the placement of central venous lines, relative to current standard practice and produce guidance to the NHS in England and Wales.

Background: Central venous lines are used in hospitals for seriously ill patients, to monitor their general status, or to administer drugs and give intravenous feeding. Over 1 million are used annually in England and Wales. Most are inserted using surface landmarks. There are potentially serious complications arising from incorrect insertion; these complication rates vary from 0.3 - 12%, depending on the skill of the operator. The technique is particularly difficult in children and infants and incorrect insertion is more likely to lead to more serious complications, such as puncture of the adjoining arteries.

Technology: This new technique uses ultrasound technology to help locate veins for insertion of central venous lines and can identify anatomical variations in individual patients.


Ultrasound locating devices for placing central venous lines.


Patients requiring central venous lines, e.g. the critically ill, some cancer patients

Current standard treatments (comparators)

Standard landmark placement techniques

Other considerations

· Added value for different target groups should be explored.

· Differences in outcomes depending on the access site chosen (subclavian, jugular etc) should be evaluated.

· Variation in success rates / complications amongst different operators should be identified and if there is variation, the reasons should be explored

.· Service implications should be assessed.

· The possible use of this technology for training purposes should be evaluated.

This page was last updated: 30 March 2010