Better With Ultrasound: Arterial Line Placement

Chest. 2020 Mar;157(3):574-579. doi: 10.1016/j.chest.2019.08.2209. Epub 2019 Oct 18.


Arterial catheterization is frequently performed in ICUs to facilitate hemodynamic monitoring and frequent blood sampling. Overall, arterial catheterization has high success and low complication rates, but in patients who are critically ill, the incidence of failure is higher because of hypotension, peripheral edema, and obesity. Ultrasound guidance significantly increases the likelihood of successful cannulation and decreases complications compared with traditional landmark-based techniques. Multiple ultrasound techniques for radial and femoral arterial catheter insertion have been described; this paper presents an approach for incorporating these tools into bedside practice, including illustrative figures and narrated video presentations to demonstrate the techniques described.

Keywords: critical care; medical education; ultrasound.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Aneurysm, False / epidemiology
  • Catheterization, Peripheral / methods*
  • Embolism, Cholesterol / epidemiology
  • Femoral Artery / surgery*
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Hemorrhage / epidemiology
  • Radial Artery / surgery*
  • Retroperitoneal Space
  • Surgery, Computer-Assisted / methods
  • Ultrasonography / methods*