Voies veineuses profondes chez l'adulte : cathétérisme sous échographie

Central venous access is used for administering pharmaceutical agents, parenteral nutrition and/or haemodialysis. The use of cutaneous landmarks is associated with a 10-15% incidence of mechanical complications, including by descending order: failure of the procedure, arterial puncture, and catheter misplacement. There is also a 3.8% incidence of pneumothorax. Serious complications, fortunately rare, are related to arterial puncture or catheter placement. Such complications are associated to anatomical changes only documented by ultrasonography. Indeed, ultrasound guidance increases the success rate, decreases the incidence of complication, improve the safety of the procedure especially in patients at risk (haemostatic disorders, unusual positioning), while decreasing the duration of catheter placement.