Randolph et al7 1996 | 8 RCTs | Mixed hospital adult & paediatric inpatients undergoing CVC insertion | Doppler- and External-ultrasound guidance, versus Landmark | Reduced IJ & SC failure rate. | No emergency vs routine subgroup analysis. |
| 513 CVC placements in 493 patients. | | | Reduced complication rate. | No Doppler vs 2-D ultrasound analysis. |
| | | | Reduction in number of attempts. | Variable definitions of failure. |
| | | | | No blinded studies |
Keenan8 2002 | 17 RCTs & 1 Quasi-RCT | Mixed hospital adult & paediatric inpatients undergoing CVC insertion | Doppler ultrasound (898) and External 2-D ultrasound (1194) | Reduced failure rate. | No scoring system or dual assessment for inclusion. |
| 2092 patients | | | Reduction in number of attempts. | No emergency vs routine subgroup analysis. |
| | | | Reduced arterial puncture rate. | Variable definitions of failure. |
| | | | Increased first attempt success rate. | No blinded studies. |
| | | | Most improvement with 2-D ultrasound, IJ cannulation, less experienced clinicians. | |
Hind et al13 2003 | 18 trials | Mixed hospital adult & paediatric inpatients undergoing CVC insertion | Doppler ultrasound (6 trials) and External 2-D ultrasound (11 trials) Both (1 trial) | Lower failure rate and higher first attempt success rate for SC, IJ and FV approaches. | Study quality was assessed by component approach |
| 1646 patients | | | Some evidence for Doppler ultrasound for IJ approach. | No emergency vs routine subgroup analysis |
| | | | | No blinded studies |