Accesos vasculares en el paciente con obesidad: el rol del ultrasonido en la cirugía bariátrica

CRITICAL CARE & EMERGENGY MEDICINE VOL. 5

Vascular access in the obese patient: the role of ultrasound in bariatric surgery

Enviar Artículo

www.doi.org/10.58281/ccem060126-rev-nar-05

Mauricio Rodrigo Ríos Zúñiga 1 , Flavio Morales Vázquez 1 , José Heriberto Cuan Díaz 1 , Iván Uriel Gámez Valdez 1 .

1 Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Editor
Arturo Vázquez Peralta , Monica Yesenia Mondragon Gomez .

Chair
Manuel Alberto Guerrero Gutierrez .

Abstract

Abstract: Vascular access in patients with obesity represents a significant clinical challenge due to the anatomical and physiological alterations inherent to this population, increasing the need for more precise and safer strategies for catheter placement and maintenance. Current evidence, supported by international guidelines, consensus statements, and clinical studies, consistently demonstrates that the use of ultrasound (US) improves first-attempt success rates, reduces complications, and shortens procedure times when compared with traditional techniques. Furthermore, contemporary guidelines recommend its systematic use in patients with obesity, emphasizing the integration of stratification algorithms based on difficult intravenous access (DIVA) risk assessment scales and the appropriate selection of vascular devices according to treatment duration and clinical context.
Altogether, these data establish ultrasound as the tool of choice for the establishment and maintenance of vascular access in patients with obesity.

Resumen:  Los accesos vasculares en pacientes con obesidad constituyen un reto clínico significativo debido a las alteraciones anatómicas y fisiológicas presentes en esta población, lo que incrementa la necesidad de generar estrategias más precisas y seguras para su colocación y cuidado. La evidencia más actual, sustentada por guías internacionales, consensos y estudios clínicos, demuestra de manera consistente que el uso del ultrasonido (US) optimiza el éxito en el primer intento, disminuye las complicaciones y reduce los tiempos de procedimiento en comparación con las técnicas tradicionales. Además, las guías actuales recomiendan su uso sistemático en pacientes con obesidad, enfatizando la importancia de integrar el uso de algoritmos de estratificación con escalas de valoración del riesgo de acceso intravenoso difícil (DIVA, por sus siglas en inglés) y una correcta selección del dispositivo a colocar según la duración del tratamiento y el contexto clínico.
En conjunto, estos datos consolidan al ultrasonido como la herramienta de elección para el establecimiento y mantenimiento de accesos vasculares en pacientes con obesidad.

Vascular access; difficult intravenous access; ultrasonography; obesity; bariatric surgery.

Mauricio Rodrigo Ríos Zúñiga
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Flavio Morales Vázquez
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

José Heriberto Cuan Díaz
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Iván Uriel Gámez Valdez
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

  1. Johnston AJ, Simpson MJ, McCormack V, Barton A, Bennett J, Chalisey A, et al. Association of Anaesthetists guidelines: safe vascular access 2025. Anaesthesia. 2025 Nov;80(11):1381-1396. doi: 10.1111/anae.16727.
  2. Lamperti M, Biasucci DG, Disma N, Pittiruti M, Breschan C, Vailati D, et al. European Society of Anaesthesiology guidelines on peri-operative use of ultrasound-guided for vascular access (PERSEUS vascular access). Eur J Anaesthesiol. 2020 May;37(5):344-376. doi: 10.1097/EJA.0000000000001180.
  3. Vegas A, Wells B, Braum P, Denault A, Miller Hance WC, Kaufman C, et al. Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography. J Am Soc Echocardiogr. 2025 Feb;38(2):57-91. doi: 10.1016/j.echo.2024.12.004.
  4. Pittiruti M, Van Boxtel T, Scoppettuolo G, Carr P, Konstantinou E, Ortiz Miluy G, et al. European recommendations on the proper indication and use of peripheral venous access devices (the ERPIUP consensus): A WoCoVA project. J Vasc Access. 2023;24(1):165-182. doi: 10.1177/11297298211023274.
  5. Franco-Sadud R, Schnobrich D, Mathews BK, Candotti C, Abdel-Ghani S, Perez MG, et al. Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019;14(9):E1-E22. doi: 10.12788/jhm.3287.
  6. Diab S, Kweon J, Farrag O, Shehata IM. The role of ultrasonography in anesthesia for bariatric surgery. Saudi J Anaesth. 2022;16:347-354. doi: 10.4103/sja.sja_80_22.
  7. Lang LH, Parekh K, Tsui BYK, Maze M. Perioperative management of the obese surgical patient. Br Med Bull. 2017;124(1):135-155. doi: 10.1093/bmb/ldx041.
  8. Latos M, Szymczak A, Solecki M. Intravenous access in patients with morbid obesity. Surgical and Vascular Nursing. 2024;18(2):71-74. doi: 10.5114/.2024.141479.
  9. Zawadka M, Andruszkiewicz P, Gola W, Wong A, Czuczwar M. Echocardiography and Ultrasound Committee statement for the accreditation programme in point-of-care ultrasonography in Poland. Anaesthesiol Intensive Ther. 2023;55(2):77-80. doi: 10.5114/ait.2023.128704.
  10. Bahl A, Johnson S, Alsbrooks K, Mares A, Gala S, Hoerauf K. Defining difficult intravenous access (DIVA): A systematic review. J Vasc Access. 2021;24(5):904-910. doi: 10.1177/11297298211059648.
  11. Rodríguez-Calero MA, Blanco-Mavillard I, Morales-Asencio JM, Fernández-Fernández I, Castro-Sánchez E, de Pedro-Gómez JE. Defining risk factors associated with difficult peripheral venous cannulation: A systematic review and meta-analysis. Heart Lung. 2020;49(3):273-286. doi: 10.1016/j.hrtlng.2020.01.009.
  12. Bahl A, Alsbrooks K, Zazyczny KA, Johnson S, Hoerauf K. An Improved Definition and SAFE Rule for Predicting Difficult Intravascular Access (DIVA) in Hospitalized Adults. J Infus Nurs. 2024;47(2):96-107. doi: 10.1097/NAN.0000000000000535.
  13. Civetta G, Cortesi S, Mancardi M, De Pirro A, Vischio M, Mazzocchi M, et al. EA-DIVA score (Enhanced Adult Difficult IntraVenous Access): a new scale to predict difficult preoperative venous cannulation in adult surgical patients. J Vasc Access. 2019;20(3):281-289. doi: 10.1177/1129729818804994.
  14. van Loon FHJ, van Hooff LWE, de Boer HD, Koopman SSHA, Buise MP, Korsten HHM, et al. The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019 Jan 26;8(2):144. doi: 10.3390/jcm8020144.
  15. Tian Y, Zhong Z, Dougarem D, Sun L. The ultrasound-guided versus standard technique for peripheral intravenous catheter placement by nurses: A systematic review and meta-analysis. Heliyon. 2024;10(9):e30582. doi: 10.1016/j.heliyon.2024.e30582.
  16. Zaki HA, Elmelliti H, Ponappan B, Shaban A, Abosamak MF, Shaban EE. Outcomes of POCUS-Guided Peripheral Intravenous Access in Difficult Venous Access Patients: A Systematic Review and Meta-Analysis. J Clin Ultrasound. 2025;53(8):1846-1859. doi: 10.1002/jcu.24059.
  17. Zhao L, Yang X, Liu C, Yu W, Cao X, Li X, et al. Comparative safety and efficacy of midline catheters versus long peripheral catheters in patients undergoing bariatric surgery: a randomised controlled trial. Sci Rep. 2025;15(1):30534. doi: 10.1038/s41598-025-12551-0.
  18. Yuan M, Liu Y, Tang L, Zhang W. A retrospective cohort study on the use of ultrasound in establishing peripheral intravenous access in emergency patients with difficult veins. Medicine (Baltimore). 2025;104(41):e44348. doi: 10.1097/MD.0000000000044348.
  19. Brandt HG, Jepsen CH, Hendriksen OM, Lindekær A, Skjønnemand M. The use of ultrasound to identify veins for peripheral venous access in morbidly obese patients. Dan Med J. 2016;63(2):A5191.
  20. Ueda K, Hussey P. Dynamic Ultrasound-Guided Short-Axis Needle Tip Navigation Technique for Facilitating Cannulation of Peripheral Veins in Obese Patients. Anesth Analg. 2017;124(3):831-833. doi: 10.1213/ANE.0000000000001653.
  21. Egan G, Healy D, O’Neill H, Clarke-Moloney M, Grace PA, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2013;30(7):521-526. doi: 10.1136/emermed-2012-201652.
  22. Bridey C, Thilly N, Lefevre T, Maire-Richard A, Morel M, Levy B, et al. Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study. BMJ Open. 2018;8(6):e020220. doi: 10.1136/bmjopen-2017-020220.
  23. Latos M, Solecki M, Szymczak A, Cichowlas G, Kosson D. “MINIMIDLINE”: Vascular Access in Specific Situations. Emerg Med Serv. 2023;X(1):4. doi: 10.36740/EmeMS202301107.
  24. Gu R, Xu S, Jiang S, Lu X, Wang H, Zhao X. Introduction of ultrasound-guided axillary vein approach for central venous catheterization in severely injured trauma patients: characteristics and concerns. Front Med (Lausanne). 2025;12:1603778. doi: 10.3389/fmed.2025.1603778.
  25. Beniamen A, Mosallem A, Ali HT, Nofal HA, Negm EM. The role of point-of-care ultrasonography in central venous catheter insertion: A randomized controlled trial of safety and cost-effectiveness. Med Intensiva (Engl Ed). 2025;49(11):502221. doi: 10.1016/j.medine.2025.502221.
  26. Saad AA, Simsekler MCE, Ahmed S, Ouda R, Khaddam O, Sanousi M, et al. Optimizing Strategies for Managing Difficult Intravenous Access. Risk Manag Healthc Policy. 2025;18:1147-1157. doi: 10.2147/RMHP.S500340.
  27. McMahon K, Thomas A, Isenberg JD. Ultrasound-Guided Intravenous Access. 2025 Jul 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30252244.
  28. Convissar D, Bittner EA, Chang MG. Biplane Imaging Versus Standard Transverse Single-Plane Imaging for Ultrasound-Guided Peripheral Intravenous Access: A Prospective Controlled Crossover Trial. Crit Care Explor. 2021 Oct 8;3(10):e545. doi: 10.1097/CCE.0000000000000545.
  29. Patankar S. Combining Infrared Vein Visualization and Ultrasound Guidance for Central Line Placement in Difficult Venous Access Patients: A Technical Report. Cureus. 2025;17(4):e83264. doi: 10.7759/cureus.83264.
  30. Moore CL. Ultrasound first, second, and last for vascular access. J Ultrasound Med. 2014;33(7):1135-1142. doi: 10.7863/ultra.33.7.1135.
  31. Boulet N, Muller L, Rickard CM, Lefrant JY, Roger C. How to improve the efficiency and the safety of real-time ultrasound-guided central venous catheterization in 2023: a narrative review. Ann Intensive Care. 2023;13(1):46. doi: 10.1186/s13613-023-01141-w.
  32. Ng M, Mark LKF, Fatimah L. Management of difficult intravenous access: a qualitative review. World J Emerg Med. 2022;13(6):467-478. doi: 10.5847/wjem.j.1920-8642.2022.104.
  33. White L, Halpin A, Turner M, Wallace L. Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis. Br J Anaesth. 2016;116(5):610-617. doi: 10.1093/bja/aew097.
  34. Foerschner L, Erhard N, Dorfmeister S, Telishevska M, Kottmaier M, Bourier F, et al. Ultrasound-Guided Access Reduces Vascular Complications in Patients Undergoing Catheter Ablation for Cardiac Arrhythmias. J Clin Med. 2022;11(22):6766. doi: 10.3390/jcm11226766.
  35. Peralta-Gámez MS, Gómez de Quero Córdoba M, Reverté-Villarroya S, Cuesta-Martínez R. Comparison of Traditional and Ultrasound-Guided Techniques for Vascular Access in Patients with Difficult Venous Access in Emergency Departments: Randomized Clinical Trial Protocol. Nursing Reports. 2025;15(5):177. doi: 10.3390/nursrep15050177.
[1] Mauricio Rodrigo Ríos Zúñiga, Flavio Morales Vázquez, José Heriberto Cuan Díaz, and Iván Uriel Gámez Valdez. 2026. Accesos vasculares en el paciente con obesidad: el rol del ultrasonido en la cirugía bariátrica. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 59–67. https://doi.org/10.58281/ccem060126-rev-nar-05
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Licencia

© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .

Licencia Creative Commons CC BY 4.0

The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.

ISSN

2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

Indexación

Patrocinadores

www.doi.org/10.58281/ccem060126-rev-nar-05

Mauricio Rodrigo Ríos Zúñiga 1 , Flavio Morales Vázquez 1 , José Heriberto Cuan Díaz 1 , Iván Uriel Gámez Valdez 1 .

1 Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Editor
Arturo Vázquez Peralta , Monica Yesenia Mondragon Gomez .

Chair
Manuel Alberto Guerrero Gutierrez .

Abstract

Abstract: Vascular access in patients with obesity represents a significant clinical challenge due to the anatomical and physiological alterations inherent to this population, increasing the need for more precise and safer strategies for catheter placement and maintenance. Current evidence, supported by international guidelines, consensus statements, and clinical studies, consistently demonstrates that the use of ultrasound (US) improves first-attempt success rates, reduces complications, and shortens procedure times when compared with traditional techniques. Furthermore, contemporary guidelines recommend its systematic use in patients with obesity, emphasizing the integration of stratification algorithms based on difficult intravenous access (DIVA) risk assessment scales and the appropriate selection of vascular
devices according to treatment duration and clinical context.
Altogether, these data establish ultrasound as the tool of choice for the establishment and maintenance of vascular access in patients with obesity.

Resumen:  Los accesos vasculares en pacientes con obesidad constituyen un reto clínico significativo debido a las alteraciones anatómicas y fisiológicas presentes en esta población, lo que incrementa la necesidad de generar estrategias más precisas y seguras para su colocación y cuidado. La evidencia más actual, sustentada por guías internacionales, consensos y estudios clínicos, demuestra de manera consistente que el uso del ultrasonido (US) optimiza el éxito en el primer intento, disminuye las complicaciones y reduce los tiempos de procedimiento en comparación con las técnicas tradicionales. Además, las guías actuales recomiendan su uso sistemático en pacientes con obesidad, enfatizando la importancia de integrar el uso de algoritmos de estratificación con escalas de valoración del riesgo de acceso intravenoso difícil (DIVA, por sus siglas en inglés) y una correcta selección del dispositivo a colocar según la duración del tratamiento y el contexto clínico.
En conjunto, estos datos consolidan al ultrasonido como la herramienta de elección para el establecimiento y mantenimiento de accesos vasculares en pacientes con obesidad.

Vascular access; difficult intravenous access; ultrasonography; obesity; bariatric surgery.

Mauricio Rodrigo Ríos Zúñiga
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Flavio Morales Vázquez
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

José Heriberto Cuan Díaz
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

Iván Uriel Gámez Valdez
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.

  1. Johnston AJ, Simpson MJ, McCormack V, Barton A, Bennett J, Chalisey A, et al. Association of Anaesthetists guidelines: safe vascular access 2025. Anaesthesia. 2025 Nov;80(11):1381-1396. doi: 10.1111/anae.16727.
  2. Lamperti M, Biasucci DG, Disma N, Pittiruti M, Breschan C, Vailati D, et al. European Society of Anaesthesiology guidelines on peri-operative use of ultrasound-guided for vascular access (PERSEUS vascular access). Eur J Anaesthesiol. 2020 May;37(5):344-376. doi: 10.1097/EJA.0000000000001180.
  3. Vegas A, Wells B, Braum P, Denault A, Miller Hance WC, Kaufman C, et al. Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography. J Am Soc Echocardiogr. 2025 Feb;38(2):57-91. doi: 10.1016/j.echo.2024.12.004.
  4. Pittiruti M, Van Boxtel T, Scoppettuolo G, Carr P, Konstantinou E, Ortiz Miluy G, et al. European recommendations on the proper indication and use of peripheral venous access devices (the ERPIUP consensus): A WoCoVA project. J Vasc Access. 2023;24(1):165-182. doi: 10.1177/11297298211023274.
  5. Franco-Sadud R, Schnobrich D, Mathews BK, Candotti C, Abdel-Ghani S, Perez MG, et al. Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019;14(9):E1-E22. doi: 10.12788/jhm.3287.
  6. Diab S, Kweon J, Farrag O, Shehata IM. The role of ultrasonography in anesthesia for bariatric surgery. Saudi J Anaesth. 2022;16:347-354. doi: 10.4103/sja.sja_80_22.
  7. Lang LH, Parekh K, Tsui BYK, Maze M. Perioperative management of the obese surgical patient. Br Med Bull. 2017;124(1):135-155. doi: 10.1093/bmb/ldx041.
  8. Latos M, Szymczak A, Solecki M. Intravenous access in patients with morbid obesity. Surgical and Vascular Nursing. 2024;18(2):71-74. doi: 10.5114/.2024.141479.
  9. Zawadka M, Andruszkiewicz P, Gola W, Wong A, Czuczwar M. Echocardiography and Ultrasound Committee statement for the accreditation programme in point-of-care ultrasonography in Poland. Anaesthesiol Intensive Ther. 2023;55(2):77-80. doi: 10.5114/ait.2023.128704.
  10. Bahl A, Johnson S, Alsbrooks K, Mares A, Gala S, Hoerauf K. Defining difficult intravenous access (DIVA): A systematic review. J Vasc Access. 2021;24(5):904-910. doi: 10.1177/11297298211059648.
  11. Rodríguez-Calero MA, Blanco-Mavillard I, Morales-Asencio JM, Fernández-Fernández I, Castro-Sánchez E, de Pedro-Gómez JE. Defining risk factors associated with difficult peripheral venous cannulation: A systematic review and meta-analysis. Heart Lung. 2020;49(3):273-286. doi: 10.1016/j.hrtlng.2020.01.009.
  12. Bahl A, Alsbrooks K, Zazyczny KA, Johnson S, Hoerauf K. An Improved Definition and SAFE Rule for Predicting Difficult Intravascular Access (DIVA) in Hospitalized Adults. J Infus Nurs. 2024;47(2):96-107. doi: 10.1097/NAN.0000000000000535.
  13. Civetta G, Cortesi S, Mancardi M, De Pirro A, Vischio M, Mazzocchi M, et al. EA-DIVA score (Enhanced Adult Difficult IntraVenous Access): a new scale to predict difficult preoperative venous cannulation in adult surgical patients. J Vasc Access. 2019;20(3):281-289. doi: 10.1177/1129729818804994.
  14. van Loon FHJ, van Hooff LWE, de Boer HD, Koopman SSHA, Buise MP, Korsten HHM, et al. The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019 Jan 26;8(2):144. doi: 10.3390/jcm8020144.
  15. Tian Y, Zhong Z, Dougarem D, Sun L. The ultrasound-guided versus standard technique for peripheral intravenous catheter placement by nurses: A systematic review and meta-analysis. Heliyon. 2024;10(9):e30582. doi: 10.1016/j.heliyon.2024.e30582.
  16. Zaki HA, Elmelliti H, Ponappan B, Shaban A, Abosamak MF, Shaban EE. Outcomes of POCUS-Guided Peripheral Intravenous Access in Difficult Venous Access Patients: A Systematic Review and Meta-Analysis. J Clin Ultrasound. 2025;53(8):1846-1859. doi: 10.1002/jcu.24059.
  17. Zhao L, Yang X, Liu C, Yu W, Cao X, Li X, et al. Comparative safety and efficacy of midline catheters versus long peripheral catheters in patients undergoing bariatric surgery: a randomised controlled trial. Sci Rep. 2025;15(1):30534. doi: 10.1038/s41598-025-12551-0.
  18. Yuan M, Liu Y, Tang L, Zhang W. A retrospective cohort study on the use of ultrasound in establishing peripheral intravenous access in emergency patients with difficult veins. Medicine (Baltimore). 2025;104(41):e44348. doi: 10.1097/MD.0000000000044348.
  19. Brandt HG, Jepsen CH, Hendriksen OM, Lindekær A, Skjønnemand M. The use of ultrasound to identify veins for peripheral venous access in morbidly obese patients. Dan Med J. 2016;63(2):A5191.
  20. Ueda K, Hussey P. Dynamic Ultrasound-Guided Short-Axis Needle Tip Navigation Technique for Facilitating Cannulation of Peripheral Veins in Obese Patients. Anesth Analg. 2017;124(3):831-833. doi: 10.1213/ANE.0000000000001653.
  21. Egan G, Healy D, O’Neill H, Clarke-Moloney M, Grace PA, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2013;30(7):521-526. doi: 10.1136/emermed-2012-201652.
  22. Bridey C, Thilly N, Lefevre T, Maire-Richard A, Morel M, Levy B, et al. Ultrasound-guided versus landmark approach for peripheral intravenous access by critical care nurses: a randomised controlled study. BMJ Open. 2018;8(6):e020220. doi: 10.1136/bmjopen-2017-020220.
  23. Latos M, Solecki M, Szymczak A, Cichowlas G, Kosson D. “MINIMIDLINE”: Vascular Access in Specific Situations. Emerg Med Serv. 2023;X(1):4. doi: 10.36740/EmeMS202301107.
  24. Gu R, Xu S, Jiang S, Lu X, Wang H, Zhao X. Introduction of ultrasound-guided axillary vein approach for central venous catheterization in severely injured trauma patients: characteristics and concerns. Front Med (Lausanne). 2025;12:1603778. doi: 10.3389/fmed.2025.1603778.
  25. Beniamen A, Mosallem A, Ali HT, Nofal HA, Negm EM. The role of point-of-care ultrasonography in central venous catheter insertion: A randomized controlled trial of safety and cost-effectiveness. Med Intensiva (Engl Ed). 2025;49(11):502221. doi: 10.1016/j.medine.2025.502221.
  26. Saad AA, Simsekler MCE, Ahmed S, Ouda R, Khaddam O, Sanousi M, et al. Optimizing Strategies for Managing Difficult Intravenous Access. Risk Manag Healthc Policy. 2025;18:1147-1157. doi: 10.2147/RMHP.S500340.
  27. McMahon K, Thomas A, Isenberg JD. Ultrasound-Guided Intravenous Access. 2025 Jul 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 30252244.
  28. Convissar D, Bittner EA, Chang MG. Biplane Imaging Versus Standard Transverse Single-Plane Imaging for Ultrasound-Guided Peripheral Intravenous Access: A Prospective Controlled Crossover Trial. Crit Care Explor. 2021 Oct 8;3(10):e545. doi: 10.1097/CCE.0000000000000545.
  29. Patankar S. Combining Infrared Vein Visualization and Ultrasound Guidance for Central Line Placement in Difficult Venous Access Patients: A Technical Report. Cureus. 2025;17(4):e83264. doi: 10.7759/cureus.83264.
  30. Moore CL. Ultrasound first, second, and last for vascular access. J Ultrasound Med. 2014;33(7):1135-1142. doi: 10.7863/ultra.33.7.1135.
  31. Boulet N, Muller L, Rickard CM, Lefrant JY, Roger C. How to improve the efficiency and the safety of real-time ultrasound-guided central venous catheterization in 2023: a narrative review. Ann Intensive Care. 2023;13(1):46. doi: 10.1186/s13613-023-01141-w.
  32. Ng M, Mark LKF, Fatimah L. Management of difficult intravenous access: a qualitative review. World J Emerg Med. 2022;13(6):467-478. doi: 10.5847/wjem.j.1920-8642.2022.104.
  33. White L, Halpin A, Turner M, Wallace L. Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis. Br J Anaesth. 2016;116(5):610-617. doi: 10.1093/bja/aew097.
  34. Foerschner L, Erhard N, Dorfmeister S, Telishevska M, Kottmaier M, Bourier F, et al. Ultrasound-Guided Access Reduces Vascular Complications in Patients Undergoing Catheter Ablation for Cardiac Arrhythmias. J Clin Med. 2022;11(22):6766. doi: 10.3390/jcm11226766.
  35. Peralta-Gámez MS, Gómez de Quero Córdoba M, Reverté-Villarroya S, Cuesta-Martínez R. Comparison of Traditional and Ultrasound-Guided Techniques for Vascular Access in Patients with Difficult Venous Access in Emergency Departments: Randomized Clinical Trial Protocol. Nursing Reports. 2025;15(5):177. doi: 10.3390/nursrep15050177.
[1] Mauricio Rodrigo Ríos Zúñiga, Flavio Morales Vázquez, José Heriberto Cuan Díaz, and Iván Uriel Gámez Valdez. 2026. Accesos vasculares en el paciente con obesidad: el rol del ultrasonido en la cirugía bariátrica. CRITICAL CARE & EMERGENGY MEDICINE 5, (January 2026), 59–67. https://doi.org/10.58281/ccem060126-rev-nar-05
PDF
HTML

Licencia

© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .

Licencia Creative Commons CC BY 4.0

The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.

ISSN

2992-6785

eISSN: 2992-6785
DOI: 10.3989/ccem

Indexación

Patrocinadores

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