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

Wang, Jiebo; Lai, Zhongmeng; Weng, Xing; Lin, Yong; Wu, Guohua; Huang, Qijian; Su, Jiansheng; Zeng, Jing; Liu, Junle; Zhao, Zisong; Yan, Ting; Zhang, Liang-Cheng; Zhou, Linying

doi:10.1101/19001586

Cited by 3 publications

(8 citation statements)

References 24 publications

(32 reference statements)

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“…17 However, the visualization of artery may be unclear sometimes, 7 which may be associated with the operator's unfamiliarity with the ultrasound-guided procedures and the different types of ultrasound instruments used. In M-LAIP approach, the special puncture posture and needle-holding mode were adopted, 17 which have the advantages of stabilizing the hand-held probe, optimizing the visual field, keeping the needle perfectly aligned with the central line of probe, and more precise . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Discussionmentioning

confidence: 99%

“…More details about this technique had been previously described. 17 In the SAOP group，after viewing the artery in a transverse approach and keeping radial artery in the middle line of the ultrasound screen, the needle was inserted at the puncture point at which the centre line of the probe contacted the skin with an angle of 15°-40° to the skin. Then the needle tip was advanced to the ultrasonic plane by short wiggles.…”

Section: Study Interventionsmentioning

confidence: 99%

“…In the palpation group, the operator performed radial artery cannulation by palpating the radial artery pulse, which had been previously described. 17 . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Study Interventionsmentioning

confidence: 99%

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Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

Wang

Zhang

Huang

et al. 2019

Preprint

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BACKGROUND Given a low first-pass success rate of the conventional SAX (short-axis) or LAX (long-axis) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameter less than 2.2 mm may be still challenging. OBJECTIVE To assess the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation. DESIGN A prospective, randomized and controlled trial. SETTING Operating room in a tertiary university hospital, from 1 July 2018 to 24 November 2018. PATIENTS A total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. Patients with history of forearm surgery, ulnar artery occlusion, abnormal Allen test, etc, were excluded from this study. INTERVENTIONS All patients were randomized 1:1:1 to M-LAIP, SAOP or C-P. MAIN OUTCOME MEASURES The primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts. RESULTS The cannulation success rate was significantly higher in the M-LAIP group than in the SAOP group or C-P group (first success rate: 80.3% vs 53.8% or 33.8%; p =0.000; total success rate: 93.9% vs 78.5% or 50.8%; p =0.000). First location time (s) was significantly longer in the M-LAIP group compared with the SAOP group (31(28-35[12-44]) vs 15(14-17[10-21]); p =0.000) and the C-P group (31(28-35[12-44]) vs 12(8-13.5 [6-37]); p =0.000). However, the time of cannulation in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP group (45(28.5-135.5[14-346]), p =0.002) and in the C-P group(138(27-308[12-363]), p =0.000). The number of attempts decreased in the M-LAIP group compared with SAOP or C-P group. CONCLUSION The M-LAIP procedure for ultrasound-guided radial artery cannulation can offer a higher success rate of the first-attempt and total cannulation, fewer attempts and less time of cannulation.

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Section: Discussionmentioning

confidence: 99%

Section: Study Interventionsmentioning

confidence: 99%

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Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

Wang

Zhang

Huang

et al. 2019

Preprint

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“…Finally, the needle was completely pulled out, and the catheter was connected to the transducer. More details about this technique have been previously described [18].…”

Section: Study Proceduresmentioning

confidence: 99%

A Randomized Controlled Trial of Radial Artery Cannulation Guided by Modified Long Axis Ultrasound Versus Short Axis Ultrasound Versus Palpation

Wang¹,

Zhang²,

Zhao³

et al. 2020

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Background: Given the low first-pass success rate of the conventional short-axis (SAX) or long-axis (LAX) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameters less than 2.2 mm may still be challenging. In this study, we compare the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation.Methods: This was a prospective, randomized and controlled trial, conducted from 1 July 2018 to 24 November 2018. A total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. All patients were randomized 1:1:1 to the M-LAIP, SAOP or conventional palpation (C-P) approach. The primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts. The Chi-square (χ2) test was used to compare categorical data between 3 groups.Results: The cannulation success rate was significantly higher in the M-LAIP group than in the SAOP or C-P groups (first success rate: 80.3% vs 53.8% or 33.8%; p < 0.001; total success rate: 93.9% vs 78.5% or 50.8%; p < 0.001). First location time (seconds) was significantly longer in the M-LAIP group (31(28-35[12-44])) than in the SAOP (15(14-17[10-21]); p < 0.001) and C-P groups (12(8-13.5 [6-37]). However, the cannulation time (seconds) in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP (45(28.5-135.5[14-346]); p = 0.002) and the C-P groups (138(27-308[12-363]); p < 0.001). The number of attempts was lower in the M-LAIP group compared with SAOP or C-P group (1.29±0.63 vs 1.8±0.89 or 2.22±0.93, p < 0.001).Conclusions: The use of the M-LAIP approaches significantly improved the success rate of radial artery cannulation in adults with radial artery diameters less than 2.2 mm, compared with that achieved with the use of traditional short-axis out-of-plane approach.Trial registration: ClinicalTrials.gov; No: ChiCTR-IOR-17011474; URL: http: // www. chictr.org. cn/index.aspx. Registered 24 June 2018.

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“…Arterial cannulation is a common invasive procedure that enables beat-to-beat blood pressure monitoring, frequent blood sampling and the assessment of fluid responsiveness in operating rooms and intensive care units [1,2]. Different sites can be chosen for arterial cannulation, but the radial artery is most commonly used due to its superficial course, its dual blood supply to the hand, and a low rate of complications [3].…”

Section: Introductionmentioning

confidence: 99%

Dynamic needle tip positioning versus the angle-distance technique for ultrasound-guided radial artery cannulation in adults: a randomized controlled trial

et al. 2020

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Background Ultrasound guidance can increase the success rate and reduce the incidence of complications of arterial cannulation. There are few studies on the utility of the dynamic needle tip positioning (DNTP) technique versus the angle-distance (AD) technique for ultrasound-guided radial arterial cannulation in adult surgical patients. We assessed and compared the success rates and incidences of complications of these two short-axis out-of-plane techniques. Methods A total of 131 adult surgical patients were randomized into DNTP and AD groups to undergo ultrasound-guided radial artery cannulation. The primary outcome was first-pass success without posterior wall puncture. The secondary outcomes included the first-pass success rate, 10-min overall success rate, cannulation time, posterior wall puncture, and the number of skin punctures. Results The first-pass success rates without posterior wall puncture were 53.8% in the DNTP group and 44.6% in the AD group (RR = 1.22, 95% CI: 0.86–1.72; P = 0.26). The cannulation time was significantly longer (P = 0.01) in the DNTP group [79.65 (54.3–109.4) seconds] than in the AD group [47.6 (24.9–103.8) seconds]. The posterior wall puncture rate was significantly lower (P = 0.002) in the DNTP group (29.2%) than in the AD group (56.1%; RR = 0.56, 95% CI: 0.42–0.82). Conclusions There were no significant differences in the first-pass success rate, with or without arterial posterior wall puncture, or in the 10-min overall success rate between the DNTP and AD groups. However, the cannulation time was longer and the posterior wall puncture rate was lower in the DNTP group. Trial registration The trial was registered at www.clinicaltrials.gov (No: NCT03656978). Registered 4 September 2018.

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

Cited by 3 publications

References 24 publications

Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

A Randomized Controlled Trial of Radial Artery Cannulation Guided by Modified Long Axis Ultrasound Versus Short Axis Ultrasound Versus Palpation

Dynamic needle tip positioning versus the angle-distance technique for ultrasound-guided radial artery cannulation in adults: a randomized controlled trial

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