Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis

White, Leigh; Audrey, Halpin, Alice,; Turner, Marianne; Wallace, L A

doi:10.1093/bja/aew097

Cited by 107 publications

(54 citation statements)

References 17 publications

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“…Using US for arterial line placement has proven itself in the perioperative setting 4,8,[13][14][15][16] and in several systematic reviews. 9,[17][18] In one systematic review, Shiloh et al demonstrated that "compared with the palpation method, ultrasound guidance for arterial catheterization was associated with a 71% improvement in the likelihood of first-attempt success. "…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Wilson

Rose

Kelen

et al. 2020

WestJEM

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Section: Discussionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Wilson

Rose

Kelen

et al. 2020

WestJEM

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“…Data in the literature about the role of US in intravascular AC infections are scarce. The current literature mostly focus only on first-attempt failure, mean attempts to success, mean time to success, and the occurrence of hematoma or venipuncture complications [3][4][5]. Interestingly, all RCTs investigating the role of US for the radial artery in adults assessed only non-infectious complications, thus disregarding intravascular catheter infections [12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials

Buetti

Ruckly

Lucet

et al. 2020

Ann. Intensive Care

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Background: The impact on infectious risk of ultrasound guidance at insertion remains controversial in short-term arterial catheters (ACs). The present study investigated the association between ultrasound guidance (US) during AC insertion and major catheter-related infections (MCRI), catheter-related bloodstream infections (CR-BSI) or colonization, using univariate and multivariate marginal Cox model for clustered data. The skin colonization at catheter removal was evaluated to explain our results. Results: We used individual data from two multicenter randomized-controlled trials (RCTs) that included a total of 3029 patients, 10 ICUs and 3950 ACs. US guidance was used for 386 (9.8%) catheter placements. In the univariate Cox model analysis, AC insertion with US versus without US exhibited similar risks for MCRI (HR 0.86, CI 95% 0.27-2.72, p = 0.79), CR-BSI (HR 0.87, CI 95% 0.20-3.72, p = 0.85) and catheter colonization (HR 1.31, CI 95% 0.92-1.86, p = 0.13). After adjustment on confounders, risks associated with US guidance remained similar versus non-US for MCRI (HR 0.71, CI 95% 0.23-2.24, p = 0.56), CR-BSI (HR 0.71, CI 95% 0.17-3.00, p = 0.63) and catheter colonization (HR 0.92, CI 95% 0.63-1.34, p = 0.67). No differences between US and non-US for MCRI, CR-BSI and colonization were observed according to the insertion site, radial or femoral. At catheter removal, the skin colonization was similar between US and non-US groups (p = 0.69). Conclusions: Using the largest dataset ever collected from large multi-centric RCTs conducted with relatively consistent insertion and maintenance catheter protocols, we showed that the risk of infectious complications for ACs inserted under US guidance is not superior compared to those inserted without US guidance. Trial registration These studies were registered within ClinicalTrials.gov (numbers NCT01629550 and NCT 01189682).

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“…It has revolutionised many areas of critical care including vascular access [1], the trauma survey [2] and point of care diagnositic imaging [3]. Transthoracic echocardiography (TTE) is currently the preferred method in assessing cardiac function and haemodynamic status despite its well-known limitations [4].…”

Section: Commentarymentioning

confidence: 99%

Transesophageal echocardiography: A new era for the critical care physician

White¹

2016

Trauma Emerg Care

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CommentaryMedical ultrasound is a ground breaking frontier of medicine, particularly in regard to point of care investigation and intervention. It has revolutionised many areas of critical care including vascular access [1], the trauma survey [2] and point of care diagnositic imaging [3]. Transthoracic echocardiography (TTE) is currently the preferred method in assessing cardiac function and haemodynamic status despite its well-known limitations [4]. For this reason a number of studies have investigated the feasibility and applications of transesophageal echocardiography (TEE) in the critical care setting [4][5][6].In 2013, Charron et al., performed a study investigating the minimum training requirements of non-cardiologists to perform an advanced point of care TEE [5]. In this study, each participant was an intensive care trainee with little or no experience with echocardiography. These trainees were then trained in advanced TEE and assessed at one, three and six months. This study found that the performance of at least 31 examinations over six months were required to reach competence in advanced TEE.In 2015, Arntfield, et al., expanded on the use of TEE as an additional form of basic point of care ultrasound in the emergency department [6]. This study trained a small group of emergency physicians experienced in TTE to perform a basic four view TEE [6]. During a four hour simulation session these physicians were taught to obtain and interpret the mid oesophageal four chamber, mid-esophageal long axis, transgastric short axis and bicaval view. Six weeks later each physician was asked to obtain and interpret these same views. Eight of twelve participants felt confident in performing this task. Despite the lack of perceived confidence, all twelve were able acceptably obtain and assess mid-esophageal four chamber and mid-esophageal long axis views. Eleven of the twelve were able to demonstrate adequate transgastric short axis and bicaval views. The pathological conditions simulated were identified by 100% of participants.These diagnostic findings in simulated TEEs were then replicated in a further study by Arntfield et al., (2016) [4]. This was a retrospective review of 54 TEE examinations performed by 12 ED physicians. In this study the indications included intra cardiac arrest, post cardiac arrest and undifferentiated hypotension. The TEE studies performed the following four views; mid oesophageal four chamber (96%), midesophageal long axis (78%), transgastric short axis (80%) and bicaval (46%) view. Fifty-three of the 54 studies were determinate making it a reliable tool. Furthermore, 78% of the studies had diagnostic influence and impacted therapeutic decisions in 67% of TEEs.These studies demonstrate a much faster training curve [5,6] and greater clinical utility [4] than expected. Commonly, incorporation of TEE meets a great deal of resistance due to the cost of the TEE probe (estimated at $40,000 USD [4]), interdepartmental politics and lack of established training models [4]. Despite this resistance, the ab...

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Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis

Cited by 107 publications

References 17 publications

Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Comparison of Ultrasound-Guided Vs Traditional Arterial Cannulation by Emergency Medicine Residents

Ultrasound guidance and risk for intravascular catheter-related infections among peripheral arterial catheters: a post-hoc analysis of two large randomized-controlled trials

Transesophageal echocardiography: A new era for the critical care physician

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