Table 1 Summary of new access sites and puncture techniques data

Low internal jugular vein puncture

 Equivalent efficiency and immediate complications between the IP-LA and the OOP-SA techniques. Perhaps a slightly better efficiency and safety with the IP-OA puncture

 About the infectious data of the low IJV approach (an alternative to the classical IJV access), there is a very low level of evidence (mainly based on one observational study). Reduction of CRBSI compared to the conventional IJV puncture, but limited evidence about the equivalence of CRBSI compared to SV approach.

Supraclavicular subclavian or brachiocephalic vein puncture (IP-LA)

 Non-inferior or even superior efficiency compared to the infraclavicular proximal AV/SV puncture and to the OOP-SA IJV puncture, depending on the studies reviewed.

 Less catheter misplacements than the infraclavicular proximal AV/SV catheterization.

 Equivalent immediate complications compared to the infraclavicular SV and the OOP-IJV access sites.

 Infectious complications not or poorly documented (a small study with poor quality data collection). Further studies are needed to compare catheter-related infections with infraclavicular proximal AV/SV catheterization.

Distal axillary vein puncture

 Non-inferior efficiency compared to the proximal AV/SV puncture, but maybe more difficult puncture

 Maybe more immediate complications than the proximal AV/SV puncture (16.1 versus 6.6%, including 6.5 versus 0% of arterial punctures, non-statistically significant), but with less pneumothorax (3.3% versus 0%, non-statistically significant).

 The IP-LA technique is more used, but the IP-OA and IP-SA punctures could be good alternatives (further studies needed).

 Further studies needed to assess infectious complications