Ultrasound guidance for arterial (other than femoral) catheterisation in adults

Flumignan, Ronald Lg; Trevisani, Virgínia Fernandes Moça; Lópes, Renato D.; Baptista-Silva, Jose CC; Flumignan, Carolina Dutra Queiroz; Nakano, Luis Cu

doi:10.1002/14651858.cd013585

Cited by 6 publications

(3 citation statements)

References 41 publications

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“… 19 , 20 The use of USG to cannulate arteries has certainly improved the first attempt success with a reported rate of around 76 and 70% in experienced and inexperienced hands respectively. 4 Different methods like dynamic needle tip positioning, long axis view in-plane approach, bevel orientation, and Nitroglycerin have been used to improve first attempt success rate and to reduce complications. 21 The use of acoustic shadow to improve success rate is an easy technique and may be useful in the hands of both experts and novices.…”

Section: Discussionmentioning

confidence: 99%

“…A recent Cochrane systematic review of 48 randomized controlled studies (RCTs) concluded that ultrasound (USG) guidance improves first attempt success rates, overall success rates, and time needed for a successful procedure. 4 Another systematic review concluded that USG improves radial arterial cannulation success rate by 14–37% on the first attempt compared to the palpation method. 5 Complications associated with USG-guided AL placement and aborted attempts are less frequent compared to palpation method.…”

Section: Introductionmentioning

confidence: 99%

“… 5 Complications associated with USG-guided AL placement and aborted attempts are less frequent compared to palpation method. 4 , 6 , 7 However, USG guided AL line placement is not without problems. New trainees who are not USG trained and lack hand eye coordination might find USG assistance not so useful.…”

Section: Introductionmentioning

confidence: 99%

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Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Mishra,

Rath,

Wibrow

et al. 2024

Indian Journal of Critical Care Medicine

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A bstract Aim and background Ultrasound-guided arterial catheterization is a frequently performed procedure. Additional techniques such as acoustic shadowing-assisted ultrasound may be useful in improving success rate. This systematic review aimed to assess the efficacy of acoustic shadowing assisted ultrasound for arterial catheterization. Materials and methods PubMed, Medline, EMBASE, Cochrane Library, EMCARE, and MedNar were searched in January 2024. Randomized controlled trials comparing the first attempt success rate of arterial catheterization using acoustic shadowing ultrasound vs unassisted ultrasound were included. Data were pooled for risk ratios (RRs) using the random-effects model. Subgroup analysis was conducted based on a single or double acoustic line. Sensitivity analysis was undertaken after excluding pediatric data. The certainty of evidence (COE) was assessed using the GRADE framework. Results Six randomized controlled trials ( n = 777) were included. A meta-analysis found the first attempt success rate is significantly higher in the acoustic ultrasound group ( n = 6, RR: 0.47, 95% CI: 0.34–0.66, p ≤ 0.00001). Hematoma formation was significantly less in the acoustic ultrasound group ( n = 6, RR: 0.52, 95% CI: 0.34–0.80, p = 0.003). First attempt success was significantly higher in the single acoustic line ultrasound (USG) group compared to the unassisted ultrasound group ( n = 3, RR: 0.41, 95% CI: 0.28–0.59, p ≤ 0.00001). Sensitivity analysis after excluding pediatric data was similar to the primary analysis ( n = 5, RR: 0.50, 95% CI: 0.33–0.70, p ≤ 0.00001). Certainty of evidence was “Moderate” for the first attempt cannulation. Conclusions Acoustic shadowing-assisted ultrasound improved first-attempt arterial catheterization success rate and was associated with reduced hematoma formation. How to cite this article Mishra L, Rath C, Wibrow B, Anstey M, Ho K. Acoustic Shadowing to Facilitate Ultrasound Guided Arterial Cannulation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Indian J Crit Care Med 2024;28(7):677–685.

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