Evidence Summary for Ultrasound-Guided Peripheral Arterial Catheter Placement in Adult Critical Care Patients

Ultrasound guidance can improve the success and safety of peripheral arterial catheter placement in critically ill adult patients; however, existing evidence is scattered and lacks a graded, clinically actionable synthesis. This evidence summary aimed to systematically retrieve, evaluate, and synthesize evidence on ultrasound-guided peripheral arterial catheter placement in critically ill adult patients, in order to inform evidence-based nursing practice.

This evidence summary was conducted following the methodological framework recommended by the Joanna Briggs Institute (JBI) for evidence synthesis. A top-down search was performed based on the "6S" evidence pyramid model to identify relevant clinical guidelines, systematic reviews, and randomized controlled trials. Twenty databases and resources including UpToDate, Embase, and PubMed were systematically searched from inception until August 31, 2025.

A total of 20 publications were included: 3 clinical guidelines, 12 systematic reviews, and 5 randomized controlled trials. From these, 29 discrete evidence recommendations were extracted and synthesized, covering six key aspects: puncture site selection, catheterization procedures and recommendations, comparison of puncture approaches, ultrasound imaging and probe techniques, ultrasound equipment and auxiliary tools, and training.

This evidence summary provides 29 graded recommendations for ultrasound-guided peripheral arterial catheter placement in critically ill adult patients. Implementing these recommendations can increase first-attempt success, decrease complications, and improve patient safety. Adoption should be tailored to local equipment availability and clinical context, while adhering to core evidence-based principles.

This study was registered with the Center for Evidence-Based Nursing at Fudan University (Registration No. ES20245973). URL: http://ebn.nursing.fudan.edu.cn/home.