Necessary additional steps in ultrasound guided central venous catheter placement: getting to the heart of the matter

With great interest we read the recent article on ultrasound (US)-guided central venous catheter (CVC) placement by Saugel et al. [1] and we completely agree with the authors on the importance of US guidance in CVC placement. However, we do believe that their protocol is incomplete. The authors' recommendations rely solely on wire, needle, and CVC position confirmation in the entry vein, which does not provide the physician with information regarding correct CVC position or placementassociated complications.