PMID- 34353670 OWN - NLM STAT- MEDLINE DCOM- 20220127 LR - 20220127 IS - 1879-291X (Electronic) IS - 0301-5629 (Linking) VI - 47 IP - 11 DP - 2021 Nov TI - Efficacy of Ultrasound-Guided Peripheral Intravenous Cannulation versus Standard of Care: A Systematic Review and Meta-analysis. PG - 3068-3078 LID - S0301-5629(21)00299-4 [pii] LID - 10.1016/j.ultrasmedbio.2021.07.002 [doi] AB - Peripheral intravenous cannulation (PIV) is a common and necessary procedure in the emergency department (ED). Patients with PIV access encounter significant treatment delay. Ultrasound guidance for PIV (USGPIV) cannulation is a modality to reduce delay of care in such patients, but its efficacy, when compared with cannulation by the standard of care (SOC), the landmark and palpation method, has not been well established. We performed a random effects meta-analysis of available literature that compared USGPIV with SOC cannulation. We searched PubMed, Scopus and EMBASE until October 2020 for eligible studies in adult patients. We excluded non-English language, non-full-text studies. Our primary outcome was rate of first successful cannulation. Other outcomes were number of attempts and patient satisfaction. After identifying 284 studies and screening 74 studies, we included 10 studies. There were 1860 patients, 966 (52%) in the USGPIV group and 894 (48%) who received the SOC. Sixty-six percent of patients were female. USGPIV cannulation was associated with a two-times higher likelihood of first successful cannulation (odds ratio: 2.1, 95% confidence interval [CI]: 1.65-2.7, p < 0.001, I(2) = 2.9%). While procedure length was similar in both groups, USGPIV was associated with a significantly smaller number of attempts (standardized mean difference [SMD]: -0.272, 95% CI: -0.539 to -0.004, p = 0.047) and significantly higher patient satisfaction (SMD: 1.467, 95% CI: 0.92-2.012, p < 0.001). There was low heterogeneity among our included studies, which were mostly randomized control trials. Our study confirmed that USGPIV cannulation offers a more effective modality, compared with SOC, to improve quality of care for patients with difficult PIV access. CI - Copyright (c) 2021 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved. FAU - Tran, Quincy K AU - Tran QK AD - Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA; Program in Trauma, The R. Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland, USA; Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. FAU - Fairchild, Matthew AU - Fairchild M AD - Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. FAU - Yardi, Isha AU - Yardi I AD - Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. FAU - Mirda, Danielle AU - Mirda D AD - Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. FAU - Markin, Katherine AU - Markin K AD - Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. FAU - Pourmand, Ali AU - Pourmand A AD - Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: Pourmand@gwu.edu. LA - eng PT - Journal Article PT - Meta-Analysis PT - Review PT - Systematic Review DEP - 20210803 PL - England TA - Ultrasound Med Biol JT - Ultrasound in medicine & biology JID - 0410553 SB - IM MH - Adult MH - *Catheterization, Peripheral MH - Female MH - Humans MH - Palpation MH - *Standard of Care MH - Ultrasonography MH - Ultrasonography, Interventional OTO - NOTNLM OT - Emergency department OT - Intravenous OT - Peripheral intravenous cannulation OT - Ultrasound guided COIS- Conflict of interest disclosure The authors declare that they have no conflicts of interest. EDAT- 2021/08/07 06:00 MHDA- 2022/01/28 06:00 CRDT- 2021/08/06 05:45 PHST- 2021/03/05 00:00 [received] PHST- 2021/07/07 00:00 [revised] PHST- 2021/07/08 00:00 [accepted] PHST- 2021/08/07 06:00 [pubmed] PHST- 2022/01/28 06:00 [medline] PHST- 2021/08/06 05:45 [entrez] AID - S0301-5629(21)00299-4 [pii] AID - 10.1016/j.ultrasmedbio.2021.07.002 [doi] PST - ppublish SO - Ultrasound Med Biol. 2021 Nov;47(11):3068-3078. doi: 10.1016/j.ultrasmedbio.2021.07.002. Epub 2021 Aug 3.