Ultrasound-guided arterial cannulation in infants improves success rate

Schwemmer, Ulrich; Arzet, H. A.; Trautner, Herbert; Rauch, Stefan; Roewer, Norbert; Greim, Clemens‐Alexander

doi:10.1017/s0265021506000275

Cited by 143 publications

(108 citation statements)

References 18 publications

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“…Schwemmer et al studied 30 infants and reported an improved success rate as well as fewer attempts in the US group as compared with the DP group. 15 On the other hand, in another prospective trial involving 152 children by Ganesh et al, US guidance did not facilitate faster cannulation of the radial artery. 24 A possible explanation for this may again relate to operator inexperience.…”

Section: Discussionmentioning

confidence: 90%

“…This may partly relate to the fact that comparatively few data exist on the potential advantages of US-guided radial artery insertion. While a number of studies before 2014 have reported an increase in first-attempt success rate, fewer attempts, and a shorter overall time for catheter insertion, 5,14,15 others found no advantage to using Doppler US, 16 save for a select group of patients with hemorrhagic shock. 17 In 2014, two systematic reviews/meta-analyses of randomized controlled trials dedicated to US-guided radial artery catheterization were published.…”

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confidence: 99%

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Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists

Peters

Schwarz

Yarnold

et al. 2015

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists

Peters

Schwarz

Yarnold

et al. 2015

Can J Anesth/J Can Anesth

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“…Indeed, a number of studies have shown that US guidance has been proven to reduce complications and increase success rates for radial artery catheter placement. 3,5,[7][8][9][10] Our study is limited because we did not systematically record the US technique used (transverse, longitudinal, or static), the subject's body habitus, or the indication for arterial line placement. In addition, our assessment of pulse strength was subjective and intrapractitioner variability is possible.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Radial Artery Catheter Placement by Respiratory Therapists Using Ultrasound Guidance

Miller¹,

Cappiello²,

Gentile³

et al. 2014

Respir Care

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BACKGROUND: The use of ultrasound (US) guidance for radial artery cannulation has been shown to improve first attempt success rate, reduce time to successful cannulation, and reduce complications. We sought to determine whether properly trained respiratory therapists (RTs) could utilize US guidance for the placement of radial artery catheters. Primary outcome measurements were successful cannulation and first attempt success rate. Secondary outcomes included the effect of systolic blood pressure, prior attempts, palpable pulse strength, and gender in relation to USguided radial artery cannulation success rates. METHODS: RTs certified in arterial catheter insertion were trained in radial artery catheterization using US by emergency medicine physicians. Subjects were enrolled based on the need for an arterial catheter placement. The catheters and US devices used were standardized. Data recorded included pulse strength, systolic and diastolic blood pressure, number of attempts, and successful/unsuccessful artery cannulation. All catheterization attempts were performed according to institutional policy and procedure. RESULTS: One hundred twenty-two radial artery catheter insertion attempts were made between December of 2008 and October of 2011, in patients in whom the treating physician requested RT radial artery cannulation. The overall success rate was 86.1%, whereas the first attempt success rate was 63.1%. There was no difference found between the overall mean success rate for weak or absent pulses, age, systolic blood pressure, gender, or prior attempts. Conclusion: RTs can effectively utilize US technology to place radial artery catheters. Systolic blood pressure, prior attempts, and gender are not reliable predictors of success for US-guided radial artery cannulation. Training on the use of US should be strongly encouraged for all practitioners who place radial artery catheters.

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“…[3][4][5][6] Ultrasound guidance has been proven to be beneficial for radial artery catheter placement and can be utilized effectively by RTs. 1,[8][9][10][11][12] In the most recent systematic review and meta-analysis, which included 447 ultrasound attempts versus 455 palpation attempts, Gao et al 13 concluded that ultrasound significantly increased first-attempt success rate. For all subjects, ultrasound was associated with a risk ratio of 1.47 for first-attempt success; for adult subjects, the risk ratio was 1.38, and for pediatric subjects, the risk ratio was 1.73.…”

Section: Radial Artery Cannulationmentioning

confidence: 99%

Review of Ultrasound-Guided Radial Artery Catheter Placement

Miller

Bardin

2015

Respir Care

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Introduction Radial Artery Cannulation Ultrasound Techniques Discussion ConclusionsRadial artery catheters are commonly placed for continuous blood pressure monitoring, frequent arterial blood gas analysis, or frequent blood sampling for diagnostic testing. Radial artery cannulation can be challenging and ultrasound guidance has emerged as a valuable adjunct for the placement of radial artery catheters. The advantages of ultrasound guidance include: real-time visualization of landmarks, improved pre-procedure planning, reduction in complications, less time spent at the bedside, and improved first-attempt success rates. Disadvantages of ultrasound guidance include: equipment cost, equipment availability, limited availability of experts to train providers, and the cost of training providers. Ultrasound machines are readily available and widely utilized in many emergency departments, operating rooms, and ICUs. We will summarize the use of ultrasound guidance for the placement of radial artery catheters and describe the techniques used during ultrasound-guided arterial catheter placement. Training on the use of ultrasound should be encouraged for all practitioners who place radial artery catheters.

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Ultrasound-guided arterial cannulation in infants improves success rate

Abstract: The current pilot study suggests that ultrasound guidance is appropriate for radial artery catheter insertion, sharing many of the benefits of ultrasound-guided central vein catheter insertion.

Cited by 143 publications

References 18 publications

Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists

Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists

Analysis of Radial Artery Catheter Placement by Respiratory Therapists Using Ultrasound Guidance

Review of Ultrasound-Guided Radial Artery Catheter Placement

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