SynthesisThe journal of vascular access2026
The efficacy of ultrasound-guided peripheral intravenous cannulation versus the landmark technique in emergency department patients with difficult intravenous access: A systematic review and meta-analysis.
Synthesis in The journal of vascular access, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- A Comparison of 18-Gauge and 20-Gauge Short Peripheral Catheters in Terms of Pain and Procedural Difficulty: A Randomized Controlled Trial in the Emergency Department.Medicina (Kaunas, Lithuania) · 2026Trial
- Commentary on: Outcomes of Intravenous Normal Saline Infusion Pre-Cardiac Implantable Electronic Devices Versus no Infusion in Fasting.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Evaluation of a Portable Ultrasound System for Peripheral Intravenous Access: Performance and Safety in a Clinical Setting.Medical devices (Auckland, N.Z.) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe aim of this study was to review the evidence comparing the traditional landmark technique with the ultrasound-guided cannulation technique for peripheral intravenous catheter insertion in emergency department patients with difficult intravenous access (DIVA).
methodsA systematic review and meta-analysis was performed in accordance with PRISMA-guidelines. The protocol was prospectively registered on PROSPERO (CRD42024573146). PubMed, Cochrane, EMBASE, and CINAHL were searched between August 2024 and April 2025. Bias assessment was performed using Revised Cochrane Risk of Bias tool for randomized trials. Randomized controlled trials of emergency department patients with DIVA were eligible for inclusion. The primary outcome was first-attempt success rate. Secondary outcomes were number of intravenous insertion-attempts and patient satisfaction. A random-effects meta-analysis plot using DerSimonian and Laird method was used to calculate risk ratio (RR) of the primary outcome measure.
resultsEight randomized controlled trials with a total of 1477 emergency department patients were included in the review and 940 patients in the meta-analysis. The use of ultrasound in the emergency setting was associated with a higher first-attempt success rate (RR, 1.80; 95% CI, 1.18-2.73; DISCUSSION: Ultrasound guided cannulation improved the first-attempt success rate compared to the traditional landmark technique in patients with DIVA. Future policy makers should consider the use of ultrasound guidance as the first choice in order to reduce unnecessary insertion attempts in emergency department patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.