Publish in this journal
Journal Information
Share
Share
Download PDF
More article options
ePub
Original article
Available online 2 March 2023
Arterial cannulation in adult critical care patients: A comparative study between ultrasound guidance and palpation technique
Canulación arterial en pacientes adultos de cuidados críticos: un estudio comparativo entre la guía ecográfica y la técnica palpatoria
Visits
...
Shreyas Guttea, Afzal Azima,
Corresponding author
afzala@sgpgi.ac.in

Corresponding author.
, Banani Poddara, Mohan Gurjara, Anup Kumarb
a Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow 226014, India
b Department of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Raebareli Road, Lucknow 226014, India
Highlights

  • First study comparing USG vs. direct palpation technique at three arterial sites.

  • First attempt success rate of 83.3% vs. 55.6% in USG vs. direct palpation group.

  • Comparison of both techniques in VIS > 10 and BMI ≥ 25, was a unique part.

  • Key limitation: Single-center study with small sample size.

Received 27 October 2022. Accepted 23 January 2023
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (7)
Show moreShow less
Abstract
Objective

To compare first attempt success rate for ultrasound-guided (USG) versus direct palpation (DP) for radial, femoral, and dorsalis pedis artery cannulations in adult intensive care unit (ICU) patients.

Design

Prospective randomized clinical trial.

Setting

Mixed adult ICU of a University Hospital.

Participants

Adult patients (≥18 years) admitted to the ICU requiring invasive arterial pressure monitoring were included. Exclusion criteria were patients with a pre-existing arterial line and cannulated with other than a 20-gauge cannula for radial and dorsalis pedis artery.

Intervention

Comparison of arterial cannulation by USG versus palpation technique in radial, femoral and dorsalis pedis arteries.

Main variables of interest

Primary outcome was first attempt success rate, secondary outcomes were assessing time for cannulations, number of attempts, overall success rate, complications, and comparison of two techniques on patients requiring vasopressor.

Results

201 patients were enrolled in study, with 99 randomized to DP group and 102 to USG group. Arteries (radial, dorsalis pedis, femoral) cannulated in both groups were comparable (P = .193). Arterial line was placed on first attempt in 85 (83.3%) in USG group versus 55 (55.6%) in DP group (P = .02). Cannulation time in USG group was significantly shorter compared to DP group.

Conclusions

In our study, USG arterial cannulation, compared to palpatory technique, had a higher success rate at first attempt and a shorter cannulation time.

Clinical Trial Registry of India number

CTRI/2020/01/022989.

Keywords:
Arterial catheterization
Ultrasonography
Radial artery
Femoral artery
Critical illness
List of abbreviations:
BMI
CVC
DBP
DP Group
ED
ICU
MAP
SBP
USG Group
VIS
Resumen
Objetivo

Comparar la tasa de éxito al primer intento de la técnica eco-dirigida (USG) versus la técnica palpatoria para la canulación de la arteria radial, femoral y dorsal del pie en pacientes adultos de la unidad de cuidados intensivos (UCI).

Diseño

Ensayo clínico aleatorizado prospectivo.

Ámbito

UCI mixta de adultos de un Hospital Universitario.

Participantes

Se incluyeron pacientes adultos (≥18 años) ingresados en la UCI que requirieron monitorización invasiva de la presión arterial. Los criterios de exclusión fueron la presencia de un catéter arterial preexistente y canulados con una cánula distinta del calibre 20 para la arteria radial y dorsal del pie.

Intervención

Comparación de la canulación arterial por USG versus la técnica palpatoria en la arteria radial, femoral y pedia.

Principales variables de interés

El resultado primario fue la tasa de éxito al primer intento; los resultados secundarios fueron evaluar el tiempo requerido para lograr una canulación exitosa, el número de intentos, la tasa de éxito general, las complicaciones y la comparación de dos técnicas en pacientes que requirieron vasopresores.

Resultados

201 pacientes fueron reclutados en el estudio, con 99 aleatorizados al grupo DP y 102 al grupo USG. El número de canulaciones en las tres arterias fue similar entre ambos grupos (P = ,193). La línea arterial se colocó en el primer intento en 85 (83,3%) en el grupo USG versus 55 (55,6%) en el grupo DP (P = ,02). El tiempo de canulación en el grupo USG fue significativamente menor en comparación con el grupo de DP.

Conclusiones

En nuestro trabajo, la canulación arterial ecodirigida, en comparación con la técnica palpatoria, tuvo una mayor tasa de éxito al primer intento y un menor tiempo de canulación.

Número del Registro de EnsayosClínicos de la India

CTRI/2020/01/022989.

Palabras clave:
Cateterismo arterial
Ultrasonografía
Arteria radial
Arteria femoral
Enfermedad crítica

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?