Central Line Insertion Review for Anesthesiologists: Review Article

Abstract

Central venous catheter (CVC) is an essential tool for monitoring hemodynamics and intravenous access in many healthcare settings and, by far, most in a dynamic environment such as the operating room. It's one of the most frequent invasive procedures performed by clinicians in their practice. The literature describes many different approaches that use anatomical landmarks. However, Practice guidelines published in 2020 by the American Society of Anesthesiologists recommend the confirmation of a guide wire and central line insertion in the vein by real-time ultrasound US. This recommendation has significant practical implications, as it can lead to a reduction in adverse events following the CVS insertion. A large multicentre cohort study done in 2022, after implying the use of ultrasound-guided, reviewed the rate of adverse events following the CVS insertion and identified a variety of reasons linked with higher complication rates. A recent randomized trial compared techniques used in central line was conducted on neonates coming to the operating room who had CVS catheter placement done by pediatric anesthesiologists concluded that the modified technique was superior in regards to time efficiency and safety. This article aims to review basic knowledge and recent relevant literature about the topic in order to provide anesthesiologists with a deeper understanding of it while performing the procedure.