Attie Gabriela Araújo, Flumignan Carolina Dutra Queiroz, Silva Melissa Andreia de Moraes, Barros Edivando de Moura, Daolio Raul Muffato, Guedes Neto Henrique Jorge, Baptista-Silva José Carlos Costa, Amorim Jorge Eduardo de, Nakano Luis Carlos Uta, Flumignan Ronald Luiz Gomes
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.
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.
Sao Paulo Med J. 2019 Aug 29;137(3):284-291. doi: 10.1590/1516-3180.2019.0113070519.
Ultrasonography is currently used in investigating many vascular diseases, especially for guiding vascular access.
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.
Review of SRs, conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo.
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.
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.
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.
超声检查目前用于多种血管疾病的研究，尤其是用于指导血管通路的建立。
本文旨在总结Cochrane系统评价（SR）中关于超声引导下血管通路作为一种干预方法的效果的证据。
在圣保罗联邦大学血管与血管内外科进行的SR综述。
在Cochrane系统评价数据库中进行广泛检索，以获取评估超声引导作为一种进行任何血管通路的治疗方法的效果的Cochrane SR。对纳入的所有综述的关键特征和结果进行了总结和讨论。
纳入了3篇关于各年龄段静脉通路的SR和1篇关于儿科参与者动脉通路的综述。证据的确定性为低到中等，表明超声提高了首次穿刺成功率和手术的总体成功率；并降低了围手术期和术后不良事件的总发生率、穿刺次数、成功所需时间和置管失败率。
低到中等质量的证据表明，超声引导下的血管通路似乎降低了围手术期和术后并发症/不良反应的总发生率、穿刺次数、成功所需时间以及成人静脉置管失败率和儿童动脉穿刺失败率。缺乏关于成人超声引导下动脉穿刺的信息。为得出确凿结论，仍需进一步研究，尤其是关于动脉超声引导通路的研究。
