“Modified Dynamic Needle Tip Positioning” Short-Axis, Out-of-Plane, Ultrasound-Guided Radial Artery Cannulation in Neonates

Abstract Background: Given the low first-pass success rate of the conventional short-axis (SAX) or long-axis (LAX) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameters less than 2.2 mm may still be challenging. In this study, we compare the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation.Methods: This was a prospective, randomized and controlled trial, conducted from 1 July 2018 to 24 November 2018. A total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. All patients were randomized 1:1:1 to the M-LAIP, SAOP or conventional palpation (C-P) approach. The primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts. The Chi-square (χ2) test was used to compare categorical data between 3 groups.Results: The cannulation success rate was significantly higher in the M-LAIP group than in the SAOP or C-P groups (first success rate: 80.3% vs 53.8% or 33.8%; p < 0.001; total success rate: 93.9% vs 78.5% or 50.8%; p < 0.001). First location time (seconds) was significantly longer in the M-LAIP group (31(28-35[12-44])) than in the SAOP (15(14-17[10-21]); p < 0.001) and C-P groups (12(8-13.5 [6-37]). However, the cannulation time (seconds) in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP (45(28.5-135.5[14-346]); p = 0.002) and the C-P groups (138(27-308[12-363]); p < 0.001). The number of attempts was lower in the M-LAIP group compared with SAOP or C-P group (1.29±0.63 vs 1.8±0.89 or 2.22±0.93, p < 0.001).Conclusions: The use of the M-LAIP approaches significantly improved the success rate of radial artery cannulation in adults with radial artery diameters less than 2.2 mm, compared with that achieved with the use of traditional short-axis out-of-plane approach.Trial registration: ClinicalTrials.gov; No: ChiCTR-IOR-17011474; URL: http: // www. chictr.org. cn/index.aspx. Registered 24 June 2018.

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Modified Long-Axis In-Plane Ultrasound Versus Short-Axis Out-of-Plane Ultrasound For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

10.1101/19005496 ◽

2019 ◽

Author(s):

Jiebo Wang ◽

Liangcheng Zhang ◽

Qijian Huang ◽

Zhongmeng Lai ◽

Guohua Wu ◽

...

Keyword(s):

Success Rate ◽

Radial Artery ◽

Controlled Trial ◽

Short Axis ◽

Ultrasound Guided ◽

Radial Artery Cannulation ◽

Artery Cannulation ◽

Out Of Plane ◽

Cannulation Success Rate ◽

Cannulation Success

BACKGROUNDGiven a low first-pass success rate of the conventional SAX (short-axis) or LAX (long-axis) approach, ultrasound-guided radial artery cannulation in adults with radial artery diameter less than 2.2 mm may be still challenging.OBJECTIVETo assess the efficacy of modified long-axis in-plane(M-LAIP) versus short-axis out-of-plane (SAOP) or conventional palpation(C-P) approaches for ultrasound-guided radial artery cannulation.DESIGNA prospective, randomized and controlled trial.SETTINGOperating room in a tertiary university hospital, from 1 July 2018 to 24 November 2018.PATIENTSA total of 201 patients (age 18 to 85 years, the diameter of the radial artery less 2.2 mm) were included. Patients with history of forearm surgery, ulnar artery occlusion, abnormal Allen test, etc, were excluded from this study.INTERVENTIONSAll patients were randomized 1:1:1 to M-LAIP, SAOP or C-P.MAIN OUTCOME MEASURESThe primary outcome was the cannulation success rate. Secondary outcomes included first location time and cannulation time, number of attempts.RESULTSThe cannulation success rate was significantly higher in the M-LAIP group than in the SAOP group or C-P group (first success rate: 80.3% vs 53.8% or 33.8%; p =0.000; total success rate: 93.9% vs 78.5% or 50.8%; p =0.000). First location time (s) was significantly longer in the M-LAIP group compared with the SAOP group (31(28-35[12-44]) vs 15(14-17[10-21]); p =0.000) and the C-P group (31(28-35[12-44]) vs 12(8-13.5 [6-37]); p =0.000). However, the time of cannulation in the M-LAIP group (29(24-45[16-313])) was significantly shorter than that in the SAOP group (45(28.5-135.5[14-346]), p =0.002) and in the C-P group(138(27-308[12-363]), p =0.000). The number of attempts decreased in the M-LAIP group compared with SAOP or C-P group (1.29±0.63 vs 1.8±0.89 or 2.22±0.93, p =0.000).CONCLUSIONThe M-LAIP procedure for ultrasound-guided radial artery cannulation can offer a higher success rate of the first-attempt and total cannulation, fewer attempts and less time of cannulation.TRIAL REGISTRATIONThe study was registered at ClinicalTrials.gov (http://www.chictr.org.cn/index.aspx, number: ChiCTR-IOR-17011474).

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Ultrasound-Guided Out-of-Plane Versus In-Plane Radial Artery Cannulation in Adult Cardiac Surgical Patients

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2020.08.025 ◽

2021 ◽

Vol 35 (1) ◽

pp. 84-88 ◽

Cited By ~ 2

Author(s):

Nishant Ram Arora ◽

Madan Mohan Maddali ◽

Rashid Ahmed Rashid Al-Sheheimi ◽

Hajer Al-Mughairi ◽

Sathiya Murthi Panchatcharam

Keyword(s):

Radial Artery ◽

Surgical Patients ◽

Ultrasound Guided ◽

Radial Artery Cannulation ◽

Artery Cannulation ◽

Out Of Plane ◽

Plane Versus

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Comparison of success rates of different methods of Ultrasound guided radial artery cannulation (short axis and long axis methods) against traditional palpatory method in adult patients- a prospective randomised study.

Turkish Journal of Anaesthesiology and Reanimation ◽

10.5152/tjar.2021.1364 ◽

2021 ◽

Author(s):

Mounica Rajasekar ◽

◽

Senthilkumar Sukumar ◽

Venkatesh Selvaraj ◽

◽

...

Keyword(s):

Radial Artery ◽

Adult Patients ◽

Short Axis ◽

Success Rates ◽

Ultrasound Guided ◽

Radial Artery Cannulation ◽

Randomised Study ◽

Artery Cannulation ◽

Prospective Randomised Study

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Modified Short-Axis Out-of-Plane Ultrasound Versus Conventional Long-Axis In-Plane Ultrasound to Guide Radial Artery Cannulation

Anesthesia & Analgesia ◽

10.1213/ane.0000000000000242 ◽

2014 ◽

Vol 119 (1) ◽

pp. 163-169 ◽

Cited By ~ 27

Author(s):

ZheFeng Quan ◽

Ming Tian ◽

Ping Chi ◽

YingHao Cao ◽

Xin Li ◽

...

Keyword(s):

Radial Artery ◽

Short Axis ◽

Radial Artery Cannulation ◽

Artery Cannulation ◽

Out Of Plane

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Comparison of three ultrasound-guided radial artery cannulation methods performed by anaesthesia residents: A prospective randomized controlled trial

10.21203/rs.3.rs-152370/v1 ◽

2021 ◽

Author(s):

Yingli Cao ◽

Jingxin Su ◽

Hang Fan ◽

Kang Kang ◽

Jiaqiang Zhang ◽

...

Keyword(s):

Success Rate ◽

Radial Artery ◽

Controlled Trial ◽

Return Time ◽

Ultrasound Guided ◽

Radial Artery Cannulation ◽

Clinical Trial Registry ◽

Artery Cannulation ◽

Radial Artery Catheterization ◽

Out Of Plane

Abstract BackgroundTo compare the short-axis/out-of-plane (SAX), long-axis/in-plane (LAX) and oblique-axis/out-of-plane (OAX) approaches for radial artery catheterization performed by anaesthesia residents with limited experience.MethodsTwo hundred and sixteen adult patients were scheduled to undergo surgery requiring continuous arterial pressure monitoring. They were randomized to the SAX, LAX and OAX groups at a 1:1:1 ratio. Thirty-three anaesthesia residents performed the cannulation procedures. The operators received an explanation of the theoretical anatomy of the radial artery and the operating process of three approaches for ultrasound-guided cannulation of the radial artery and practised artery cannulation on a model of radial artery cannulation. The primary outcome was the success rate of cannulation, and the secondary outcomes included the first-attempt success rate in the model and patients, the imaging time, blood return time, cannulation time, total time and incidence of adverse events.ResultsThe success rate of radial artery cannulation in the SAX group was significantly higher than that in the LAX group (71.4% vs 49.2%; P=0.009) and was clinically meaningfully higher than that in the OAX group (71.4% vs 61.7%; P=0.229). The total time was shorter in the SAX group than in the LAX and OAX groups: 51 (59) s vs 113 (66) s vs 86 (61) s; P=0.000. The first-attempt success rate for the model did not differ among the three groups. In the patients, the first-attempt success rate in the SAX group was significantly higher than those in both the LAX and OAX groups (69.7% vs 24.2% vs 6.1%; P=0.000).ConclusionAnaesthesia residents can achieve a higher success rate, higher satisfaction rate and shorter procedure time by using the SAX approach than by using the LAX and OAX approaches for radial artery catheterization.Trial registrrationChinese Clinical Trial Registry,ChiCTR200030416. Registered 1 March 2020,http://www.chictr.org.cn/edit.aspx?pid=50193&htm=4

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