Observational studyAnaesthesia2026
An observational study of pre-hospital central venous access for patients with haemorrhagic shock due to major trauma.
Observational study in Anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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
3 citing papers in PubMed.
- Real-time ultrasound guidance for central venous access: a reply.Anaesthesia · 2026Article
- Real-time ultrasound guidance for central venous access.Anaesthesia · 2026Article
- The impact of advanced pre-hospital interventions on scene time.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionExsanguinating haemorrhagic shock due to major trauma is associated with high mortality. Rapid intravenous volume replacement with blood products is a crucial element of early treatment. When peripheral intravenous access cannot be obtained, pre-hospital placement of a large-calibre central venous catheter, known as a trauma line, can be a life-saving alternative.
methodsThis was a retrospective cohort study to evaluate the feasibility, efficacy and safety profile of inserting a 14-Fr trauma line in patients with exsanguinating haemorrhage due to major trauma in the pre-hospital setting. Success rates, outcomes and complications of trauma line insertion were determined by cross-referencing pre-hospital patient care records with emergency department notes, operating notes and post-mortem findings.
resultsBetween 1 January 2019 and 31 July 2023, London's Air Ambulance attended 8104 patients. Trauma line insertion was attempted in 346 (4%) patients with success in 276 (80%). Successful trauma line insertion was associated with significantly greater transfusion of pre-hospital blood products compared with those in whom insertion was unsuccessful (median (IQR [range]) 4 (2-6 [0-12]) vs. 2 (0-4 [0-8]) units, respectively; p < 0.001). Survival to presentation to the emergency department was higher after successful trauma line insertion (149/279 (54%) vs. 25/70 (36%); p = 0.006). There were 184 (53%) patients transported to hospital. Complications in this group were reported in 8 (4%) patients: malpositioned trauma line (n = 3); vascular injuries (n = 2); iatrogenic pneumothorax (n = 2); and positive trauma line tip culture (n = 1). DISCUSSION: In patients with exsanguinating haemorrhage who are in severe shock or traumatic cardiac arrest, pre-hospital trauma line insertion is feasible and associated with an acceptable risk of procedural complications. Trauma lines enable the delivery of a greater volume of blood products in the pre-hospital setting, which may be associated with increased pre-hospital survival.
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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 Socratic graph.