A Novel Method for Ultrasound-Guided Radial Arterial Catheterization in Pediatric Patients

Abstract

Ultrasound-guided radial artery catheterization in pediatric patients was fastest and most reliable when the artery was 2 to 4 mm below the skin surface. For arteries located <2 mm below the skin surface, increasing the depth to 2 to 4 mm by subcutaneous saline injection reduced catheterization time and improved the success rate.

Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children

“…These studies reported final success rates of 65 to 100% for ultrasound-guided techniques. 3,[12][13][14] In this study, the final success rate ranged between 88 and 100%, in agreement with the results of earlier studies and demonstrating a relatively high performance in infants, regardless of the ultrasound-guided arterial cannulation technique used.…”

“…Nakayama et al 3 suggested that ultrasound-guided radial artery catheterisation in children was fastest and most reliable when the artery was 2 to 4 mm below the skin surface. In this study, both the radial artery and posterior tibial artery were included with a mean depth of 3.1 AE 1.1 mm (range 1.4 to 6.3 mm), which was within their recommended range.…”

“…2 Different ways of facilitating arterial cannulation in children have been explored, including ultrasound guidance and puncture depth adjustment using ultrasound. 3 Ultrasound guidance has been useful for vascular access, demonstrating increased safety and efficiency over conventional methods. 4 Many guidelines have recommended the use of ultrasound-guided vascular access both in adults and children.…”

Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access

“…This increases the ability to visualize the needle tip once through the skin to direct it to the vessel . Similarly, a technique using the subcutaneous injection of saline has been shown to facilitate arterial ultrasound‐guided catheterization in infants . Despite these challenges, the technique can be mastered with practice.…”

Successful arterial cannulation in neonates: the ‘hanging drop’ technique

“…Recently Nakayama et al . improved the success rate of ultrasound‐guided radial artery catheterization in pediatric patients with superficial arteries by injecting saline to increase the depth of artery to 2–4 mm. The arteries in neonates often go into spasm during cannulation delaying blood return to the hub of the cannula.…”