Ultrasound-guided vs. palpation-guided techniques for radial arterial catheterisation in infants

Min, Jeong Jin; Tay, Cho Jui; Gil, Nam-Su; Lee, Jong‐Hwan; Kim, Sojin; Kim, Chung S.; Yang, Ji-Hyuk; Jun, Tae-Gook

doi:10.1097/eja.0000000000000926

Cited by 33 publications

(20 citation statements)

References 23 publications

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“…Nonetheless, in most situations, children with non-cyanotic congenital heart disease have good exposure of peripheral veins, which prevents the ultrasound method from showing its advantage of visualization compared with the traditional landmark method. The success rate of the rst attempt was used as one of the crucial metrics by many studies to evaluate the effectiveness of peripheral venipuncture [3,16]. But no consistent conclusions have been drawn about the in uence of the use of ultrasound on the success rate at the rst attempt of peripheral venous access.…”

Section: Discussionmentioning

confidence: 99%

The effect of the use of the ultrasound-assisted technique versus traditional anatomic landmark approach for the saphenous venous cannulation in infants and toddlers with congenital heart disease: a randomized controlled trial

Bian¹,

Huang²,

Bai³

et al. 2020

Preprint

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Background: The study investigated the success rate of the great saphenous venous catheter placement performed by ultrasound-assisted technique compared with the anatomical landmark approach in infants and toddlers with congenital heart disease and aimed to assess the efficiency and feasibility of this ultrasound-assisted method within the scope of pediatric peripheral intravenous access.Methods: We selected infants and toddlers who underwent congenital cardiac surgery in our medical center from June 1, 2020, to September 7, 2020, by convenience sampling. Children were stratified by the presence of the manifesting cardiac types (cyanotic or acyanotic heart disease). They were assigned to the traditional anatomical landmark group and the ultrasound-assisted group through randomly blocked randomization. The primary outcome was the success rate of the first attempt. The second outcomes included the time to cannulation at the first attempt, the redirections of the first attempt, overall puncture time, and overall redirections of efforts. Besides, a binary logistic regression model was implemented to identify the possible variables related to the success rate of the first attempt.Results: A total of 144 children in our medical center were recruited in the study. The success rate of the first attempt in the ultrasound-assisted group was higher than that of the traditional anatomic landmark group in the stratification of cyanotic children（66.7% vs. 33.3%, P=0.035）. Among children of acyanotic kind, the difference in the success rate of the first attempt between the two groups was not significant（57.6% vs. 42.4%, P= 0.194）. Overall puncture time （45.5 s vs. 94 s, P= 0.00）and the time to cannulation at the first attempt （41.0 s vs. 60 s, P= 0.00）in the ultrasound-assisted group was less than the traditional landmark group. The ultrasound-assisted group also required fewer redirections of the first attempt (three attempts vs. seven attempts, P=0.002) and fewer total redirections of efforts (two attempts vs. three attempts, P=0.027) than the traditional landmark group. The result of binary Logistic regression showed that the success rate of the first attempt was related to age（OR：1.141; 95% CI=1.010-1.290, P=0.034）, the redirections of the first attempt （OR：0.698; 95% CI=0.528 -0.923, P=0.012）and the saphenous venous width（OR：1.181; 95% CI=1.023 -1.364, P=0.023）.Conclusions: The ultrasound-assisted technique improves the saphenous venous cannulation sufficiently in children with difficult peripheral veins. The younger age is associated with a higher likelihood of peripheral venous difficulty. The ultrasound-assisted method could effectively screen peripheral veins, such as selecting peripheral veins with a thicker diameter, less puncture discomfort, and a better success rate. This method can be used as a useful and practical way for peripheral venipuncture in children, especially in a difficult situation. It should be widely applied in the operating room. Trial registration: ChiCTR.org.cn(ChiCTR-2000033368). Prospectively registered May 29, 2020.

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Section: Discussionmentioning

confidence: 99%

The effect of the use of the ultrasound-assisted technique versus traditional anatomic landmark approach for the saphenous venous cannulation in infants and toddlers with congenital heart disease: a randomized controlled trial

Bian¹,

Huang²,

Bai³

et al. 2020

Preprint

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“…It may be more suitable for cases of difficult cannulation of the radial artery, considering that the ultrasound technique may increase the cost to the patient. For some patients with high risk factors for difficult cannulation of radial artery, such as artery diameter less than 2.2 mm, critically ill children, 25 infants, 26 it is not clear whether this technique has advantages over traditional ultrasound and palpation techniques. Three anesthesiologists in the CA1, CA3 and CA5 groups were involved in the study, so the Hawthorne effect could not be completely excluded.…”

Section: Discussionmentioning

confidence: 99%

Modified Long-Axis In-Plane Ultrasound Technique Versus Conventional Palpation Technique For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

Wang

Lai

Weng

et al. 2019

Preprint

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Background: A low first-pass success rate of radial artery cannulation was obtained when using the conventional palpation technique(C-PT) or ultrasound-guided techniques, we therefore evaluate the effect of a modified long-axis in-plane ultrasound technique (M-LAINUT) in guiding radial artery cannulation in adults. Methods：We conducted a prospective, randomized and controlled clinical trial of 288 patients undergoing radial artery cannulation. Patients were randomized 1:1 to M-LAINUT or C-PT group at fujian medical university union hospital between 2017 and 2018. Radial artery cannulation was performed by three anesthesiologists with different experience. The outcome was the first and total radial artery cannulation success rates, the number of attempts and the cannulation time. Results: 285 patients were statistically analyzed. The success rate of first attempt was 91.6% in the M-LAINUT group (n=143) and 57.7% in the C-PT group (n=142; P<0.001) (odds ratio, 7.9; 95% confidence interval, 4.0-15.7). The total success rate (≤5 min and ≤3 attempts) in the M-LAINUT group was 97.9%, compared to 84.5% in the palpation group (p <0.001) (odds ratio, 8.5; 95% confidence interval, 2.5-29.2). The total cannulation time was shorter and the number of attempts was fewer in the M-LAINUT group than that in the C-PT group (p <0. 05). Conclusion: Modified long-axis in-plane ultrasound-guided radial artery cannulation can increase the first and total radial artery cannulation success rates, reduce the number of attempts and shorten the total cannulation time in adults.

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“…Two hundred eighty-six articles were identified from electronic databases (excluding duplicates). After application of the inclusion and exclusion criteria, seven studies [15][16][17][18][19][20][21] were finally included in this meta-analysis. All seven studies were randomized controlled trials of radial artery catheterizations.…”

Section: Literature Searchmentioning

confidence: 99%

Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials

Zhang

et al. 2020

Crit Care

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Background: The use of an ultrasound-guided technique for radial arterial catheterization has not been well established in pediatric patients. We conducted a systematic review and meta-analysis to evaluate the efficacy of the ultrasound-guided technique for radial artery catheterization in pediatric populations. Method: A systematic review of PubMed, Medline, Embase, and the Cochrane library was performed from their date of inception to December 2019. In this meta-analysis, we conducted online searches using the search terms "ultrasonography," "ultrasonics," "ultrasound-guided," "ultrasound," "radial artery," "radial arterial," "catheter," "cannula," and "catheterization." The rate of the first-attempt and total success, mean attempts to success, mean time to success, and incidence of complications (hematomas) were extracted. Data analysis was performed with RevMan 5.3.5. Results: From 7 relevant studies, 558 radial artery catheterizations were enrolled, including 274 ultrasound-guided and 284 palpation catheterizations. The ultrasound-guided technique could significantly improve the rate of firstattempt and total success (RR 1.78, 95% CI 1.46 to 2.18, P < 0.00001; RR 1.33; 95% CI 1.20 to 1.48; P < 0.00001). However, there was significant heterogeneity for the total success rate among the included studies (I 2 = 67%). The ultrasound-guided radial artery catheterization was also associated with less mean attempts and mean time to success (WMD − 1.13, 95% CI − 1.58 to − 0.69; WMD − 72.97 s, 95% CI − 134.41 to − 11.52) and lower incidence of the hematomas (RR 0.17, 95% CI 0.07 to 0.41). Conclusions: The use of the ultrasound-guided technique could improve the success rate of radial arterial catheterization and reduce the incidence of hematomas in pediatric patients. However, the results should be interpreted cautiously due to the heterogeneity among the studies.

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Ultrasound-guided vs. palpation-guided techniques for radial arterial catheterisation in infants

Cited by 33 publications

References 23 publications

The effect of the use of the ultrasound-assisted technique versus traditional anatomic landmark approach for the saphenous venous cannulation in infants and toddlers with congenital heart disease: a randomized controlled trial

The effect of the use of the ultrasound-assisted technique versus traditional anatomic landmark approach for the saphenous venous cannulation in infants and toddlers with congenital heart disease: a randomized controlled trial

Modified Long-Axis In-Plane Ultrasound Technique Versus Conventional Palpation Technique For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials

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