Palmar Warming for Radial Artery Vasodilation to Facilitate Transradial Access: A Randomized Controlled Trial

Al-Hakim, Ramsey; Hedge, J. Cody; Jahangiri, Younes; Kaufman, John A.; Galuppo, Roberto; Farsad, Khashayar

doi:10.1016/j.jvir.2018.10.021

Cited by 2 publications

(4 citation statements)

References 14 publications

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“…There may have been cases of insufficient warming, such as a short warming time due to the position of the skin thermometer near a warmer resulting in insufficient heat conduction which may have led to insufficient vasodilation. In one study, vasodilation occurred at 5–10 min after the application of heat ( 7 ). In another study, at temperatures between 37–42 ℃, the blood flow increased steadily and reached a maximum at 1 h; the peak flow at 45 ℃ was presented at 30 min ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…The temperature used for local warming (39 ℃) was based on that from previous studies ( 7 , 10 ). All participants had skin temperature probes (Philips Intellivue, Philips, Amsterdam, Holland) attached on their wrist.…”

Section: Methodsmentioning

confidence: 99%

“…An increase in body temperature can cause peripheral vasodilation by activating the cholinergic vasodilator system ( 5 , 6 ). Previous studies observed radial artery (RA) vasodilation or resolution of vasospasm under local warming; however, there are only few studies comparing the first-attempt success rate of peripheral arterial catheterization ( 7 - 9 ). Therefore, we aimed to compare the influence of local warming at the RA catheterization site in adult patients undergoing cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

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Effect of local warming for arterial catheterization in adult cardiac surgery: a randomized controlled trial

Park,

Kim,

Heo

et al. 2023

J Thorac Dis

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Background The increase in internal diameter (ID) and cross-sectional area (CSA) may facilitate better arterial catheterization. Since an increase in body temperature can cause peripheral vasodilation, we aimed to determine if local warming of the radial artery (RA) catheterization site could improve the success rate of catheterization. Methods This randomized, controlled study enrolled 160 patients aged >18 years who were scheduled for heart surgery. They were randomized into non-warming palpation (NP), non-warming ultrasonography-guided (NU), warming palpation (WP), and warming ultrasonography-guided (WU) groups. After induction, the baseline RA ultrasonography images were collected. In the warming groups (WP, WU), local warming was applied on the catheterization site. Before catheterization, the RA ultrasonography images were collected. The primary outcome was the first-attempt success rate. The secondary outcomes included the ID and CSA of the RA and overall complications. Results Totally 152 adults were included in the analysis. The first-attempt success rates in each of the four groups were not significantly different (P=0.985). The rates in the non-warming (NP + NU) and warming (WP + WU) groups were also not different (P=0.827). Unlike non-warming group, the warming group had increased ID (3.34±0.78 vs. 3.02±0.73 mm; P<0.001) and CSA (6.9±2.8 vs. 5.8±2.4 mm 2 ; P<0.001) compared with baseline. Conclusions Local warming for peripheral artery catheterization does not increase the first-attempt success rate in adults undergoing cardiac surgery; however, it can increase the ID and CSA of the RA and prevent vasospasm. Trial Registration ClinicalTrials.gov NCT04969692.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of local warming for arterial catheterization in adult cardiac surgery: a randomized controlled trial

Park,

Kim,

Heo

et al. 2023

J Thorac Dis

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“…With the study participant seated comfortably, an Allen’s test was performed to ensure adequate collateral perfusion throughout both the right and left hands [ 38 ]. A small heating pad was then placed into the participant’s non-dominant hand to promote vasodilation of the target artery and the wrist was prepped and draped to provide a sterile field.…”

Section: Methodsmentioning

confidence: 99%

Exposure to Non-Steady-State Oxygen Is Reflected in Changes to Arterial Blood Gas Values, Prefrontal Cortical Activity, and Systemic Cytokine Levels

Damato,

Piktel,

Margevicius

et al. 2024

IJMS

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Onboard oxygen-generating systems (OBOGSs) provide increased inspired oxygen (FiO2) to mitigate the risk of neurologic injury in high altitude aviators. OBOGSs can deliver highly variable oxygen concentrations oscillating around a predetermined FiO2 set point, even when the aircraft cabin altitude is relatively stable. Steady-state exposure to 100% FiO2 evokes neurovascular vasoconstriction, diminished cerebral perfusion, and altered electroencephalographic activity. Whether non-steady-state FiO2 exposure leads to similar outcomes is unknown. This study characterized the physiologic responses to steady-state and non-steady-state FiO2 during normobaric and hypobaric environmental pressures emulating cockpit pressures within tactical aircraft. The participants received an indwelling radial arterial catheter while exposed to steady-state or non-steady-state FiO2 levels oscillating ± 15% of prescribed set points in a hypobaric chamber. Steady-state exposure to 21% FiO2 during normobaria produced arterial blood gas values within the anticipated ranges. Exposure to non-steady-state FiO2 led to PaO2 levels higher upon cessation of non-steady-state FiO2 than when measured during steady-state exposure. This pattern was consistent across all FiO2 ranges, at each barometric condition. Prefrontal cortical activation during cognitive testing was lower following exposure to non-steady-state FiO2 >50% and <100% during both normobaria and hypobaria of 494 mmHg. The serum analyte levels (IL-6, IP-10, MCP-1, MDC, IL-15, and VEGF-D) increased 48 h following the exposures. We found non-steady-state FiO2 levels >50% reduced prefrontal cortical brain activation during the cognitive challenge, consistent with an evoked pattern of neurovascular constriction and dilation.

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Palmar Warming for Radial Artery Vasodilation to Facilitate Transradial Access: A Randomized Controlled Trial

Cited by 2 publications

References 14 publications

Effect of local warming for arterial catheterization in adult cardiac surgery: a randomized controlled trial

Effect of local warming for arterial catheterization in adult cardiac surgery: a randomized controlled trial

Exposure to Non-Steady-State Oxygen Is Reflected in Changes to Arterial Blood Gas Values, Prefrontal Cortical Activity, and Systemic Cytokine Levels

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