© The Board of Management and Trustees of the British Journal of Anaesthesia 2005
CORRESPONDENCE |
Difficulty in using ultrasonography for central venous cannulation in children: ‘a case of old dogs and new tricks’?
* E-mail: sverghese@cnmc.org
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Editor—We would like to comment on the conclusions reached by Grebenik and colleagues in a recent paper titled ‘NICE guidelines for central venous catheterization in children. Is the evidence base sufficient?’1 In this paper, the authors questioned the recommendations on the use of the ultrasound from recent guidelines from the National Institute for Clinical Excellence (NICE).2 Based on their own study, Grebenik and colleagues concluded that there is currently insufficient evidence to support the use of ultrasound guidance as the preferred method for elective central venous catheterization in children.1 While not wishing to elaborate on whether or not the available evidence justifies the NICE guidelines, we would like to make some comments regarding Grebenik and colleagues' interpretation of the methodology and conclusions of two studies from our institution that were used to support the NICE guidelines.3 4
In both our studies, the procedures were performed by anaesthesia fellows ‘who were closely
Washington, DC, USA
* E-mail: thomas.grau@med.uni-heidelberg.de
Heidelberg, Germany
E-mail: o.dearlove@man.ac.uk
Manchester, UK
E-mail: kategreb@btinternet.com
Oxford, UK