Ultrasound visual image-guided vs Doppler auditory-assisted radial artery cannulation in infants and small children by non-expert anaesthesiologists: a randomized prospective study

Ueda, Kenichi; Puangsuvan, S.; Hove, M. A.; Bayman, Emine O.

doi:10.1093/bja/aes383

Cited by 61 publications

(48 citation statements)

References 15 publications

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“…These studies reported final success rates of 65 to 100% for ultrasound-guided techniques. 3,[12][13][14] In this study, the final success rate ranged between 88 and 100%, in agreement with the results of earlier studies and demonstrating a relatively high performance in infants, regardless of the ultrasound-guided arterial cannulation technique used.…”

Section: Discussionsupporting

confidence: 91%

“…14 Previous studies on ultrasoundguided arterial cannulation have shown a diverse range of operators' skill: some restricted operators of ultrasound-guided arterial cannulation to those experienced in its use, 3,10,12 and others did not. [13][14][15] The guidelines published by The Royal College of Radiologists recommended that more than 20 ultrasound-guided vascular access attempts in adults are needed for an operator to be competent. 16 Regarding the small vessel sizes in children, operator experience may play a critical role in successful cannulation.…”

Section: Discussionmentioning

confidence: 99%

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Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children

Song

Choi

Lee

et al. 2016

European Journal of Anaesthesiology

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children

Song

Choi

Lee

et al. 2016

European Journal of Anaesthesiology

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“…Of 95 potentially relevant articles identified initially, six were included in the meta-analysis [2-7]. An additional RCT was identified from the references [8].…”

Section: Resultsmentioning

confidence: 99%

Efficacy of ultrasound-guided radial artery catheterization: a systematic review and meta-analysis of randomized controlled trials

Tie

Liu

et al. 2014

Crit Care

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IntroductionUltrasound guidance has emerged as an adjunct for central vein catheterization in both adults and children. However, the use of ultrasound guidance for radial arterial catheterization has not been well established. We conducted a systematic review and meta-analysis to evaluate the efficacy of ultrasound guidance for radial artery catheterization.MethodsPubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) comparing ultrasound guidance with other techniques (palpation or Doppler) in adult or pediatric patients requiring radial artery catheterization were included. The primary outcome was first-attempt success.ResultsSeven RCTs enrolling 546 patients met the inclusion criteria, and all the selected trials were considered as at high risk of bias. Ultrasound-guided radial artery catheterization was associated with an increased first-attempt success (relative risk (RR) 1.55, 95% confidence interval (CI) 1.02 to 2.35). There was significant heterogeneity among the studies (I2 = 74%). Ultrasound-guided radial artery catheterization in small children and infants also provided an increased chance for first-attempt success (RR 1.94, 95% CI 1.31 to 2.88). Ultrasound guidance further significantly reduced mean attempts to success (weighted mean difference (WMD) −1.13, 95% CI −1.58 to −0.69), mean time to success (WMD −72.97 seconds, 95% CI −134.41 to −11.52), and incidence of the complication of hematoma (RR 0.17, 95% CI 0.07 to 0.41).ConclusionsUltrasound guidance is an effective and safe technique for radial artery catheterization, even in small children and infants. However, the results should be interpreted cautiously due to the heterogeneity among the studies.

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“…However, several differences should be highlighted here. First, our meta-analysis specifically focused on ultrasound guidance vs. traditional palpation for radial artery catheterization and thus Ueda et al's study [27] comparing ultrasound guidance with Doppler-assisted technique was excluded, which was included in Gu et al's meta-analysis [26]. In addition, our meta-analysis included the most recently published RCT by Hansen et al in 2014 [12], which was not included in Gu et al's [26].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Guidance for Radial Artery Catheterization: An Updated Meta-Analysis of Randomized Controlled Trials

Tang

Wang

et al. 2014

PLoS ONE

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BackgroundSince a previous meta-analysis reported that ultrasound guidance was associated with a higher first-attempt success rate in catheterization of the radial artery, a number of randomized controlled trials (RCTs) have reported inconsistent results. The aim of the present study is to conduct an updated meta-analysis to clarify the role of ultrasound guidance for radial artery catheterization.MethodsA systematic literature search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted using specific search terms. Eligible studies were RCTs that compared ultrasound guidance with traditional palpation for radial artery catheterization. The Mantel-Haenszel method using the random effects model was adopted in this meta-analysis.ResultsSeven RCTs with 482 patients were included. Compared with traditional palpation, ultrasound guidance significantly increased the first-attempt success rate of radial artery catheterization (RR 1.51, 95% CI 1.07–2.14, P = 0.02). Subgroup analyses suggested that the superiority of ultrasound guidance for radial artery catheterization was significant when the technique was operated by experienced users, performed in small children and infants, and on elective procedures in the operating room. In addition, ultrasound guidance significantly reduced mean-attempts to success (WMD −1.13, 95% CI −1.58 to −0.69, P<0.00001), mean-time to success (WMD −74.77s, 95% CI −137.89s to −11.64s, P = 0.02), and the occurrence of hematoma (RR 0.17, 95% CI 0.07–0.41, P = 0.0001).ConclusionsThe present meta-analysis suggests a clear benefit from ultrasound guidance for radial artery catheterization compared with the traditional palpation. Preliminary training and familiarization with the ultrasound-guided technique is needed before applying it for radial artery catheterization, especially for inexperienced operators.

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Ultrasound visual image-guided vs Doppler auditory-assisted radial artery cannulation in infants and small children by non-expert anaesthesiologists: a randomized prospective study

Abstract: US-guided radial arterial cannulation in infants and small children provided a greater chance for success at the first attempt compared with the Doppler-assisted technique.

Cited by 61 publications

References 15 publications

Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children

Short-axis/out-of-plane or long-axis/in-plane ultrasound-guided arterial cannulation in children

Efficacy of ultrasound-guided radial artery catheterization: a systematic review and meta-analysis of randomized controlled trials

Ultrasound Guidance for Radial Artery Catheterization: An Updated Meta-Analysis of Randomized Controlled Trials

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