Original Title: Impacto de los equipos hospitalarios multidisciplinares de acceso vascular guiado por ecografía

Authors' objectives: To evaluate the safety, efficacy, and effectiveness of ultrasound-guided vascular access in patients requiring intravenous therapy, comparing its therapeutic benefits with traditional techniques. Additionally, the impact of implementing multidisciplinary teams on improving these procedures is analyzed.

Authors' results and conclusions: Studies have been identified to evaluate the effectiveness, safety, efficiency, and organizational aspects of ultrasound-guided vascular access and multidisciplinary vascular access teams in the hospital setting. Fifteen systematic reviews were identified and analyzed, providing information on the efficacy/effectiveness and safety of ultrasound-guided vascular access with critically low, low, moderate, and high-quality evidence, two systematic reviews addressing organizational aspects of ultrasound-guided cannulation, and five economic evaluation studies. In terms of efficacy/effectiveness, the results showed that ultrasoundguided cannulation can significantly increase the success rates of catheter placement and first-attempt success, particularly in patients with difficult intravenous access (DIVA), both for peripheral and central venous access. In the pediatric population, most studies showed statistically significant improvements in these variables for peripheral venous access. The use of ultrasound guidance may reduce the number of cannulation attempts, although not all studies demonstrate this reduction. Ultrasound guidance did not show a reduction in cannulation time for peripheral vascular access (PIV), but a decrease in procedure duration for central venous access (CV) was observed in the adult population. Studies on patient satisfaction showed mixed results, with higher satisfaction in DIVA patients, although only one found significant differences in the general population. Additionally, patients using a specialized vascular access team reported high levels of satisfaction, with reduced pain, and healthcare professionals experienced a lower workload. Multidisciplinary ultrasound-guided vascular access teams are composed of physicians, nurses, specialized nurses, technicians, and interventional radiologists, who present heterogeneous experience, training, and education across the various studies. In terms of costs, the results of several studies reveal that implementing a specialized vascular access team and using ultrasound for venous cannulation lead to cost and resource savings.

Authors' methods: A systematic literature search was conducted in the following reference databases until May 2023: Medline (Ovid), Embase (embase.com), Web of Science, Cochrane Library, Cinahl (Ebsco) and INAHTA. Additionally, websites such as CADTH, AHRQ, NICE, HIS, HIQA, and those belonging to the Spanish Network of Health Technology Assessment Agencies (RedETS) were explored. A search was also conducted to identify cost studies and economic evaluations in the main databases for economic studies: NHS EED and CEA Registry, as well as in the Medline and Embase Informes, estudios 22 e investigación databases, using economic terms and filters. Two independent researchers carried out the selection of studies and their quality analysis. The synthesis of results was conducted qualitatively. The quality of studies was evaluated using the AMSTAR-2 tool for systematic reviews and the FLC 3.0 tool from Osteba for economic evaluation studies.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/impacto-de-los-equipos-hospitalarios-multidisciplinares-de-acceso-vascular-guiado-por-ecografia/

Year Published: 2025

URL for published report: https://www.aetsa.org/download/05-Impacto-equipos-hospitalarios_WEB.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

DOI: 10.52766/FDHG5715

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: <p>Andalusian Agency for Health Technology Assessment (AETSA)</p>