A Prospective Comparison of Ultrasound-guided and Blindly Placed Radial Arterial Catheters

Abstract

In this study, US guidance for arterial cannulation was successful more frequently and it took less time to establish the arterial line as compared with the palpation method.

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

“…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.…”

“…18,19 While both concluded that US use is associated with improved first-attempt success, a small underlying evidence base continued, and a majority of the included trials were dedicated to pediatric patients. Until 2014, there were only three included trials on adult patients; two were conducted in an emergency department setting, 14,20 and one was performed in the operating room setting. The perioperative trial involved a mixed cohort of residents and attending anesthesiologists, many of whom had no prior experience with US-guided radial artery catheterization.…”

Epert Consensus on a Canadian Internal Medicine Ultrasound Curriculum

“…Three Delphi rounds were conducted to reach a consensus. These 16 topics included measurement of the height of the internal jugular vein, 29,30 inferior vena cava measurement, 31,32 pleural effusion and thoracentesis, 8,33,34 central line insertion and pneumothorax, 3,6,7,35,36 liver and spleen examination, 2,37 ascites and paracentesis, 9,38 the bladder, 14,39,40 cellulitis/abscess/aspirates, 41,42 arterial line insertion, 43 peripheral intravenous access, 44,45 and joint aspiration. 10 Although the evidence for the role of ultrasound in establishing peripheral intravenous access in adults is not as consistent as that in pediatric patients, 46 the group felt that learning this skill is unlikely to be harmful and may improve the care of patients.…”

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

“…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.…”