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Randomized Controlled Trial
. 2020 Jan;99(2):e18747.
doi: 10.1097/MD.0000000000018747.

Modified long-axis in-plane ultrasound technique versus conventional palpation technique for radial arterial cannulation: A prospective randomized controlled trial

Jiebo Wang  1 , Zhongmeng Lai  1 , Xianfeng Weng  1 , Yong Lin  2 , Guohua Wu  1 , Jiansheng Su  1 , Qijian Huang  1 , Jian Zeng  1 , Junle Liu  1 , Zisong Zhao  1 , Ting Yan  1 , Liangcheng Zhang  1 , Linying Zhou  3
Affiliations
Randomized Controlled Trial

Modified long-axis in-plane ultrasound technique versus conventional palpation technique for radial arterial cannulation: A prospective randomized controlled trial

Jiebo Wang et al. Medicine (Baltimore). 2020 Jan.

Abstract

Background: A low first-pass success rate of radial artery cannulation was obtained when using the conventional palpation technique (C-PT) or conventional ultrasound-guided techniques, we; therefore, evaluate the effect of a modified long-axis in-plane ultrasound technique (M-LAINUT) in guiding radial artery cannulation in adults.

Methods: We conducted a prospective, randomized and controlled clinical trial of 288 patients undergoing radial artery cannulation. Patients were randomized 1:1 to M-LAINUT or C-PT group at Fujian Medical University Union Hospital between 2017 and 2018. Radial artery cannulation was performed by 3 anesthesiologists with different experience. The outcome was the first and total radial artery cannulation success rates, the number of attempts and the cannulation time, and incidence of complications.

Results: Two hundred eighty-five patients were statistically analyzed. The success rate of first attempt was 91.6% in the M-LAINUT group (n = 143) and 57.7% in the C-PT group (n = 142; P < .001) (odds ratio, 7.9; 95% confidence interval, 4.0-15.7). The total success rate (≤5 minutes and ≤3 attempts) in the M-LAINUT group was 97.9%, compared to 84.5% in the palpation group (P < .001) (odds ratio, 8.5; 95% confidence interval, 2.5-29.2). The total cannulation time was shorter and the number of attempts was fewer in the M-LAINUT group than that in the C-PT group (P < .05). The incidence of hematoma in the C-PT group was 19.7%, which was significantly higher than the 2.8% in the M-LAINUT group (P < .001).

Conclusions: Modified long-axis in-plane ultrasound-guided radial artery cannulation can increase the first and total radial artery cannulation success rates, reduce the number of attempts, and shorten the total cannulation time in adults.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
The M-LAINUTP approach. (A) The black line on the probe is the center line to guide radial artery cannulation. (B) The needle (the white arrow) had been inserted into the anterior wall of the radial artery, the vascular wall was compressed, and the blood flow signal was weakened on the ultrasound image. (C) The image of the needle or cannula in the radial artery was clearly displayed on the ultrasound. M-LAINUTP = modified long-axis in-plane ultrasound technique.
Figure 2
Figure 2
Flow diagram of patient recruitment and randomization.
Figure 3
Figure 3
Total cannulation time in the 2 groups.
See this image and copyright information in PMC

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