Comparison of short-axis out-of-plane versus long-axis in-plane ultrasound-guided radial arterial cannulation in adult patients: a randomized controlled trial

Sethi, Sameer; Maitra, Souvik; Saini, Vikas; Samra, Tanvir; Malhotra, Samir

doi:10.1007/s00540-016-2270-6

Cited by 34 publications

(25 citation statements)

References 13 publications

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“…Three articles were excluded because the article type was a letter or meta-analysis. Ultimately, 11 studies 17 – 27 fulfilled the inclusion criteria for the meta-analysis ( Figure 1 ). The study characteristics are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analyses were performed to investigate the source of heterogeneity. In the radial artery (RA) subgroup, 19 , 21 , 26 , 27 the total success rate was no different between the SA-OOP and LA-IP groups (RR, 1.00; 95% CI, 0.96–1.05; P =0.88; I 2 =49%; Figure 3 ), and the TSA confirmed this result (the cumulative Z-curve crossed the futility boundary and entered the futility area; Figure 4A ). In the internal jugular vein (IJV) subgroup, 17 , 20 , 22 , 23 the total success rate was also no different between the SA-OOP and LA-IP groups (RR, 1.00; 95% CI, 0.98–1.02; P =0.99; I 2 =0%; Figure 3 ) and the TSA also confirmed the result (the cumulative Z-curve crossed the futility boundary and entered the futility area; Figure 4B ).…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies 17 , 19 , 21 – 27 reported the first-attempt success rate. There was no significant difference between the LA-IP approach group and the SA-OOP approach group (RR, 1.14; 95% CI, 0.96–1.35, P =0.14, I 2 =80%; Figure 5 ).…”

Section: Resultsmentioning

confidence: 99%

“… 10 First, this meta-analysis included an additional six studies. 22 – 27 Thus, this updated meta-analysis represents the latest and most comprehensive study. Second, TSA was further applied to better establish sufficient and conclusive evidence.…”

Section: Discussionmentioning

confidence: 99%

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Comparison between the long-axis/in-plane and short-axis/out-of-plane approaches for ultrasound-guided vascular catheterization: an updated meta-analysis and trial sequential analysis

Liu

Mao

Kang

et al. 2018

TCRM

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BackgroundA long-axis in-plane (LA-IP) approach and a short-axis out-of-plane (SA-OOP) approach are the two main approaches used in ultrasound (US)-guided vascular catheterization. However, the efficacy and safety of these approaches remain controversial. Therefore, we performed this meta-analysis to compare the two techniques in vascular catheterization.Materials and methodsRelevant studies were searched in PubMed, Embase, and the Cochrane Library databases from database inception until August 2017. Randomized controlled trials comparing a long-axis approach with a short-axis approach for US-guided vascular cannulation were selected. The RevMan software was used to analyze the results, and trial sequential analysis (TSA) was further applied to determine whether the currently available evidence was sufficient and conclusive.ResultsEleven studies met the inclusion criteria. Overall, 1,210 patients were included. The total success rate was similar between the SA-OOP and LA-IP approaches for US-guided vascular catheterization (risk ratio [RR], 1.01; 95% CI, 0.99–1.04; P=0.35; I2=48%). In the radial artery (RA; RR, 1.00; 95% CI, 0.96–1.05; P=0.88; I2=49%) and internal jugular vein (IJV; RR, 1.00; 95% CI, 0.98–1.02; P=0.99; I2=0%) subgroups, the total success rate was also similar and was confirmed by the TSA. For populations with subclavian vein (SCV) and axillary vein catheterization, the SA-OOP approach showed a benefit for first-attempt success rate. No significant differences in first-attempt success rate, cannulation times, or complications were found between the two approaches.ConclusionDespite a similar total success rate between the SA-OOP approach and the LA-IP approach when used for RA and IJV catheterization (as confirmed by TSA), further robust well-designed trials are warranted to evaluate other outcomes. There is insufficient evidence to definitively state that the SA-OOP approach was superior to the LA-IP approach when used for SCV and axillary vein catheterization. High-quality trials are needed to confirm or refute this finding.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison between the long-axis/in-plane and short-axis/out-of-plane approaches for ultrasound-guided vascular catheterization: an updated meta-analysis and trial sequential analysis

Liu

Mao

Kang

et al. 2018

TCRM

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“…4 Forest plot comparing the rate of first-attempt success (a) and total success (b) for ultrasound-guided versus palpation based on age vessel, collateral vasculature, and nervous structures with real-time guidance of catheter insertion for arterial catheterization. Controversy remains on which is better, the short-axis out-of-plane technique or the long-axis in-plane technique, for radial arterial catheterization [26,27]. Sethi et al [26] found that the identification of the midpoint of the radial artery on a short-axis view was probably easier with the out-of-plane technique.…”

Section: Discussionmentioning

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 arterial cannulation in the paediatric population

Raphael

Chehade

Khabsa

et al. 2023

Cochrane Database of Systematic Reviews

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Comparison of short-axis out-of-plane versus long-axis in-plane ultrasound-guided radial arterial cannulation in adult patients: a randomized controlled trial

Abstract: The first-attempt cannulation success rate and cannulation time in adult patients are similar in ultrasound-guided radial artery cannulation with both short-axis as well as long-axis techniques. Trial registration Clinical Trial Registry of India (CTRI/2015/02/005552).

Cited by 34 publications

References 13 publications

Comparison between the long-axis/in-plane and short-axis/out-of-plane approaches for ultrasound-guided vascular catheterization: an updated meta-analysis and trial sequential analysis

Comparison between the long-axis/in-plane and short-axis/out-of-plane approaches for ultrasound-guided vascular catheterization: an updated meta-analysis and trial sequential analysis

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

Ultrasound-guided arterial cannulation in the paediatric population

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