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Meta-Analysis
. 2014 Nov 6;9(11):e111527.
doi: 10.1371/journal.pone.0111527. eCollection 2014.

Ultrasound guidance for radial artery catheterization: an updated meta-analysis of randomized controlled trials

Lu Tang  1 , Fei Wang  1 , Yuxiang Li  2 , Liang Zhao  3 , Huijun Xi  4 , Zhihong Guo  1 , Xiuyun Li  5 , Chengjie Gao  1 , Jian Wang  1 , Lingjun Zhou  6
Affiliations
Meta-Analysis

Ultrasound guidance for radial artery catheterization: an updated meta-analysis of randomized controlled trials

Lu Tang et al. PLoS One. .

Abstract

Background: Since 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.

Methods: A 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.

Results: Seven 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).

Conclusions: The 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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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The flow diagram of the selection process of the included studies.
Figure 2
Figure 2. The forest plot depicting first-attempt success.
Figure 3
Figure 3. The forest plot depicting mean-attempts to success.
Figure 4
Figure 4. The forest plot depicting mean-time to success.
Figure 5
Figure 5. The forest plot depicting the occurrence of hematoma.
See this image and copyright information in PMC

References

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