Ultrasound-guided venous cannulation in a critical care unit Punção venosa guiada por ultra-som em unidade de terapia intensiva

In the intensive care setting, ultrasound guided venous cannulation has now become an essential procedure for critically ill patients, however it has risks inherent to its insertion as well as permanence. To reduce risks related to insertion, the applicability of ultrasonography to aid insertion of a central and peripheral venous catheter will be discussed. This is a technology available in our daily clinical practice with some advantages in intensive care units, such as absence of exposure of patients to radioactivity, reproducibility, low cost, practicality and portability. Further, the method is not invasive and provides important bedside information, as well as support in invasive procedures.(1-4) Initially, its use was restricted to medical radiologists and echocardiographers. However, universalization of the method and standardizing of training by some societies such as the American College of Emergency Physicians (ACEP),(5) European Federation of Societies for Ultrasound in Medidicine and Biology(6) and World Interactive Network Focused on Critical Ultrasound (WINFOCUS,(7) furthered implementation in the developed countries while it is still incipient in developing countries such as Brazil. In the last decade, applicability of this method was not merely restricted to the intensive care setting, but also to the pre-hospital emergency system, intra-operative and during cardiac arrest (CA).(8-10) Another interesting point is the growing number of publications related to the method in indexed journals, stressing its importance as a complementary tool for care of the critically ill.(11) Uri Adrian Prync Flato1, Gustavo Mascari Petisco2, Fernanda Bezerra dos Santos3