Impact of Diabetes Mellitus on Radial and Ulnar Arterial Vasoreactivity after Radial Artery Cannulation: A Randomized Controlled trial

Abstract

Background: Endothelial dysfunction associated with diabetes mellitus (DM) may influence arterial vasoreactivity after arterial stimulus, such as cannulation, and cause changes in diameter and blood flow. Despite the frequent use of arterial cannulation during anesthesia and critical care, little information is available regarding vasoreactivity of the radial and ulnar arteries and its influence on underlying DM.Methods: Forty non-DM and 40 DM patients, who required arterial cannulation during general anesthesia, were enrolled. Using duplex Doppler ultrasonography, we measured the patients' arterial diameter, peak systolic velocity, end-diastolic velocity, resistance index, and mean volume flow of both arteries at five different time points.Results: After radial artery cannulation, ulnar arterial diameter and blood flow did not significantly increase in DM group, as they did in non-DM group. Ulnar arterial resistance index significantly increased in both groups, but the degree of decrease in DM group was significantly less than non-DM.Conclusion: Ulnar artery's ability to increase blood flow for compensating the sudden reduction of radial arterial flow in DM patients was significantly less than that in non-DM patients under general anesthesia. Such attenuated vasoreactivity of ulnar artery to compensate the reduced radial arterial flow may have to be considered in radial arterial cannulation for DM patients.

Doppler ultrasonographic evaluation of radial and ulnar artery diameters and blood flow, before and after percutaneous coronary interventions

“…Therefore, the decrease in vessel lumen diameter of the catheterized artery may be associated with the increase in the flow velocity of the other artery in the same arm. With RA catheterization, the distal perfusion pressure of the capillary bed decreases, causing an increase in the pressure gradient between the UA and the capillary bed, resulting in increase of UA blood flow [17,18].…”

“…It has been demonstrated that RA cannulation would decrease RA blood flow immediately after catheter placement and the compensatory increase in UA blood flow might quickly commence. Significant changes continued after 24 hours from the beginning of monitoring [18,21]. Zhenxian et al investigated the impact of transradial coronary procedures on the RA by ultrasonography.…”