Ultrasound guidance in difficult radial artery puncture for blood gas analysis: A prospective, randomized controlled trial

Grandpierre, Romain Genre; Bobbia, Xavier; Muller, Laurent; Markarian, Thibaut; Occean, Bob-valery; Pommet, Stéphane; Roger, Claire; Lefrant, Jean Yves; Coussaye, J.-E. de La; Claret, Pierre‐Géraud

doi:10.1371/journal.pone.0213683

Cited by 10 publications

(12 citation statements)

References 31 publications

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“…However, unlike the central vein, the diameter of the radial artery is small, and despite the use of ultrasound, its first-time success rate has not yet reached a satisfactory level. Therefore, in recent years, researchers have been trying to improve the ultrasound-guided radial artery puncture technique in order to improve the first-time success rate [ 32 ]. In clinical practice, with the rapid development and popularization of ultrasound technology, more and more operators will choose ultrasound salvage when they encounter difficulties in radial artery puncture, and even choose ultrasound guidance for the first operation.…”

Section: Related Workmentioning

confidence: 99%

Observation on Application Effect of Arterial Puncture and Catheterization under Guidance of Intelligent Medical Care Ultrasound in Clinical Anesthesia

Ren

Qiang

2022

Journal of Healthcare Engineering

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In clinical anesthesia and the rescue of critically ill patients, arterial puncture and catheterization are the most commonly chosen ways to establish central arterial access for patients. Invasive arterial puncture and catheterization facilitate the grasp of real-time vital sign information of patients during surgery, which strengthens patient monitoring during surgery and improves safety. However, the traditional method of arterial puncture and cannulation through palpation of the radial artery is often prone to complications related to mechanical injury, such as hemorrhage, hematoma, and accidental perforation of the artery. Studies have shown that ultrasound-guided radial artery puncture and cannulation can shorten the puncture cannulation time, reduce the incidence of complications related to puncture cannulation, and improve the success rate of puncture cannulation. In order to verify it, this paper uses the experimental group and the control group to conduct comparative experiments and uses the neural network method to evaluate the effects of the two methods. As a more mature method of artificial intelligence, BP neural network is widely used in a wide range of applications and has the characteristics of strong generalization ability and fast convergence, so we choose it as the base model. The specific work of this paper is as follows: (1) in-depth study of the relevant theory of BP neural network (BPNN), focusing on the structure of BPNN and the working principle of algorithm; the problems to be solved in the clinical anesthesia effect evaluation have laid a theoretical foundation for the establishment of an improved BPNN evaluation model in the following chapters. (2) introduce the basic principle of genetic neural network, analyze the benefits of combining genetic neural network and BPNN; introduce in detail the process of genetic algorithm to optimize the weights and thresholds of BPNN, and establish a GA-BP evaluation model. The test proves the feasibility and superiority of the model.

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Section: Related Workmentioning

confidence: 99%

Observation on Application Effect of Arterial Puncture and Catheterization under Guidance of Intelligent Medical Care Ultrasound in Clinical Anesthesia

Ren

Qiang

2022

Journal of Healthcare Engineering

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“…In our study, the median duration of puncture with CUD was 10 seconds, with a failure rate of 2%, while it was approximately 10% in a clinical study 2 and 47% in a clinical study on difficult patients 14 . The use of a simulation model facilitated the puncture because of the simplified anatomy and optimal condition of use without patient pain, anxiety, or unwanted movements.…”

Section: Discussionmentioning

confidence: 65%

“…US guidance has also improved radial artery catheterization success for angiographic procedures in cardiology 11,12 . For diagnostic radial artery puncture for blood gas analysis, US guidance did not ensure a significant benefit in the general population in studies conducted in emergency care units 2,13 but provided an improvement in difficult patients (ie, those with a nonpalpable radial artery or two previous puncture failures by a nurse) 14 . It also decreased the puncture duration and pain.…”

Section: Introductionmentioning

confidence: 99%

Magnetic needle‐tracking device for ultrasound guidance of radial artery puncture: A randomized study on a simulation model

Grau-Mercier

Chetioui

Muller

et al. 2020

J of Clinical Ultrasound

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Introduction Ultrasound‐guidance of radial artery catheter insertion improves the first attempt success and reduces the occurrence of hematomas. Needle‐tracking devices optimize needle‐ultrasound beam alignment by displaying in real‐time the needle tip position. We compared the median time need by experienced physicians to achieve radial artery puncture using either a conventional ultrasonography device (CUD) or a magnetic needle‐tracking ultrasound device (MUD) in a simulation training arm model. Methods Fifty experienced residents and physicians performed two punctures in randomized order with the CUD and the MUD. The primary outcome was puncture duration; the secondary outcomes were puncture success, rate of accidental vein puncture, and practitioner's comfort (subjective scale 0‐10). Results The median [lower‐upper quartile] puncture time was 10 [6‐14] seconds when using CUD and 4 [3‐7] seconds when using MUD (P < .01). In the multivariate analysis, MUD use was associated with decreased puncture duration whatever the puncture order (OR 1.13 [1.07‐1.20], P < .01). The participants performed 99 (99%) successful punctures: 50 with the MUD (100%) and 49 with the CUD (98%). There was no accidental venous puncture. The practitioner's comfort level was 6.5 [6, 7] with the CUD and 8 [7‐9] with the MUD (P < .01). Conclusion MUD reduced radial artery puncture time and improved physician comfort in a simulation training arm model.

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“…The previously reported first-attempt success rates with the DNTP technique in adult patients were 83%[ 10 ] and 95% [ 15 ]. Grandpierre et al [ 28 ] showed that use of ultrasound improved the first-attempt success rate for radial artery puncture in patients with difficult-to-obtain radial arterial blood gas analysis, as defined by non-palpable radial arteries or two previous puncture failures. The use of ultrasound makes it more feasible to identify the radial artery in cases requiring multiple attempts.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided dynamic needle tip positioning technique for radial artery cannulation in elderly patients: A prospective randomized controlled study

Kim

Jeong

et al. 2021

PLoS ONE

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Background Radial artery cannulation, which is a useful procedure for anesthetic management, is often challenging in elderly patients. Recently, the dynamic needle tip positioning (DNTP) technique was introduced to facilitate ultrasound-guided vascular catheterization. Therefore, we performed this prospective, parallel group, randomized, controlled trial to compare the ultrasound-guided DNTP technique with the palpation method in elderly patients. Methods For this study, 256 patients aged 65 years or older were randomly allocated to the ultrasound-guided DNTP technique group (DNTP group) or the palpation method group (palpation group). The primary outcome was first-attempt success rate. The secondary outcomes were overall success rate, numbers of attempts and redirections, cannulation time, and incidence of complications. Results The first-attempt success rate (85.9% vs. 72.3%; relative risk [RR], 1.47; 95% CI 1.25–1.72; P<0.001) and the overall success rate (99.2% vs. 93.0%; RR, 1.07; 95% CI 1.02–1.12; P = 0.01) were significantly higher in the DNTP group compared to the palpation group. The numbers of attempts [1 (1,1) vs. 1 (1,3), P<0.001] and redirections [0 (0,1) vs. 2 (0,4), P<0.001] were significantly lower in the DNTP group. The cannulation time for successful attempts was 42 (32,55) seconds in the DNTP group and 53 (36,78) seconds in the palpation group (P<0.001). The incidence of hematoma was significantly lower in the DNTP group (7% vs. 24.2%; RR, 0.29; 95% CI, 0.14–0.59; P<0.001). Conclusions Ultrasound-guided radial artery cannulation with the DNTP technique improved the efficiency of radial artery cannulation in elderly patients by increasing the success rate while minimizing complications.

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Ultrasound guidance in difficult radial artery puncture for blood gas analysis: A prospective, randomized controlled trial

Cited by 10 publications

References 31 publications

Observation on Application Effect of Arterial Puncture and Catheterization under Guidance of Intelligent Medical Care Ultrasound in Clinical Anesthesia

Observation on Application Effect of Arterial Puncture and Catheterization under Guidance of Intelligent Medical Care Ultrasound in Clinical Anesthesia

Magnetic needle‐tracking device for ultrasound guidance of radial artery puncture: A randomized study on a simulation model

Ultrasound-guided dynamic needle tip positioning technique for radial artery cannulation in elderly patients: A prospective randomized controlled study

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