How I Do It: Ultrasound-guided Internal Jugular and Femoral Central Venous Catheter Insertion

Abstract Central venous catheterization is routinely performed in the intensive care unit to obtain venous access for hemodynamic monitoring, parenteral nutritional support, hemodialysis, and delivery of fluids & vasoactive medications. While central venous catheters can be lifesaving, their insertion is not without risk. Historically, central veins were accessed using landmark-based techniques, but the medical literature strongly supports the use of ultrasound guidance. The purpose of this article is to review the basic principles of real-time ultrasound-guided internal jugular and femoral catheter placement; an approach for incorporating these tools into clinical practice will be presented, along with illustrative figures and video.