Oblique approach for ultrasound-guided radial artery catheterization vs transverse and longitudinal approaches, a randomized trial

Abdalla, Usama; Elmaadawey, Alaa; Kandeel, A. M.

doi:10.1016/j.jclinane.2016.10.016

Cited by 17 publications

(21 citation statements)

References 17 publications

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“…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%

“…One study 26 included in this meta-analysis reported that the oblique approach for US-guided RA catheterization may replace the two classic approaches due to its superior success rate, higher first-attempt success, and shorter time consumed for catheterization with higher operator satisfaction after the procedure. Confirmation of this requires further research.…”

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: Discussionmentioning

confidence: 99%

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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“…Ultrasound-guided vascular cannulation includes an in-plane technique and out-of-plane technique [13]. Using in-plane technology, the needle trajectory from needle insertion to catheter placement is clearly visible, which seems to be effective for reducing the incidence of posterior vessel wall puncture [9].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, studies have reported that a modified ultrasound-guided short-axis technique, i.e., the dynamic needle tip positioning (DNTP) technique, is superior to the palpation technique in both adult and neonate surgical patients [6,12]. Researchers have found that when using the modified technique, after seeing the blood return, the probe needs to be moved further to ensure that the tube is in the arterial lumen before the next step is performed, and this might reduce the risk of posterior wall penetration [8,13,14]. However, this modified method requires frequent movement of the probe, which requires more operator experience and might take more time [15].…”

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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“…Depending on the results of a previous study (Abdalla et al 2017), the mean time needed for ultrasound-guided radial artery cannulation was 28 s with a standard deviation of 9 s. We considered a 20% decrease in insertion time to be clinically significant. Assuming a two-sided type I error of 0.05 and a power of 0.80, an estimated sample size of 30 patients per group was required.…”

Section: Methodsmentioning

confidence: 99%

Sonographic evaluation of peri-arterial nitroglycerine for radial artery cannulation in morbidly obese patients: a prospective randomized study

Hefnawy

Alrefaey

2018

Ain-Shams J Anesthesiol

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Background: Arterial cannulation is usually indicated for both sampling and invasive pressure monitoring. Radial artery access is increasingly favored over other sites for arterial cannulation. However, radial cannulation in morbidly obese patients is an anesthetic challenge. This study evaluates the effect of subcutaneous infiltration of nitroglycerine on radial artery cannulation in morbidly obese patients. Sixty patients were randomly allocated into two equal groups according to subcutaneous infiltrate used before radial artery cannulation. In the LN group, the syringe contains 0.2 ml of nitroglycerine (NTG) plus 0.8 ml lidocaine hydrochloride 2%, while in L group, the syringe is filled with 1 ml of lignocaine 2%. Results: Subcutaneous infiltration of the lignocaine-NTG mixture in the LN group resulted in a significant increase in arterial dimensions in comparison to lignocaine alone in the L group. Consequently, a significantly higher overall success rate, first attempt success was observed in the LN group. Also, insertion time and number of attempts were significantly lower in the LN group in relation to the L group. Conclusions: Subcutaneous infiltration of nitroglycerin mixed with a lignocaine before ultrasound-guided radial artery cannulation increases the procedure success rate with no detected side effects.

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Oblique approach for ultrasound-guided radial artery catheterization vs transverse and longitudinal approaches, a randomized trial

Cited by 17 publications

References 17 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

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

Sonographic evaluation of peri-arterial nitroglycerine for radial artery cannulation in morbidly obese patients: a prospective randomized study

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