Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists
Purpose The use of ultrasound (US) for radial arterial catheterization has been reported to result in faster insertion times with fewer complications when compared with traditional direct palpation (DP). We sought to determine if this applies to expert operators and tested the hypothesis that, among...
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| Veröffentlicht in: | Canadian journal of anesthesia 2015-11, Vol.62 (11), p.1161-1168 |
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| creator | Peters, Cheryl Schwarz, Stephan K. W. Yarnold, Cynthia H. Kojic, Katarina Kojic, Stefan Head, Stephen J. |
| description | Purpose
The use of ultrasound (US) for radial arterial catheterization has been reported to result in faster insertion times with fewer complications when compared with traditional direct palpation (DP). We sought to determine if this applies to expert operators and tested the hypothesis that, among cardiac anesthesiologists, US-guided insertion similarly results in faster insertion times as well as fewer re-directs, attempts, and complications.
Methods
Following Research Ethics Board Approval, we conducted a randomized clinical trial in 125 patients scheduled for cardiac surgery at a single tertiary/quaternary care centre. Patients were randomized to either US- or DP-guided radial artery catheterization by attending cardiac anesthesiologists. The primary endpoint was time to catheter placement. Secondary endpoints included the number of attempts and re-directs as well as the failure rate.
Results
There were no differences between the DP- (
n
= 62)
vs
US-guided (
n
= 63) groups in median [interquartile range] time to placement (104 [76–212] sec
vs
104 [68–270] sec, respectively;
P
= 0.66), number of re-directs (2 [0–6]
vs
3 [1–5], respectively;
P
= 0.82), or number of attempts (1 [1–2]
vs
1 [1–2], respectively;
P
= 0.08). The first-attempt success rate was 56.4% in the DP group and 71.4 % in the US group (
P =
0.10). Failure rate and hematoma rate in the DP group were 21.0% and 22.6%, respectively, compared with 12.7% and 11.1% in the US group (
P
= 0.24 and 0.10, respectively).
Conclusions
Among experienced cardiac anesthesiologists, the use of US to facilitate radial arterial catheterization did not affect insertion times, the number of re-directs, or the number of attempts when compared with DP. Ultrasound use had no significant effects on the rates of success on first attempt, failure, or hematoma formation. This trial was registered at
www.clinicaltrials.gov
: NCT02118441. |
| doi_str_mv | 10.1007/s12630-015-0426-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1753007304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1753007304</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-6db3d9205c3cd1a97136fb4e4ba49f01343a23eabd8da3941d761bc76a82374c3</originalsourceid><addsrcrecordid>eNp1kU-L1TAUxYMozpvRD-BGAm7cVPOvaetOHjoKA24ccFduk_SZoU3qTTr45sP4Wc2zo4jgJvdCfufkkEPIM85eccaa14kLLVnFeF0xJXTVPiA7rrqydE39kOxYK0WlOftyRs5TumGMtbpuH5MzoXndKal35Mf1lBFSXIOlh9VbCMbRW4dpTdR6dCbTBaYFso-BjhEpgvUwUcDs8EgN5K-ubP5uI4Yjdd8Xh5nGckKOmN5QKKJg4-zvnKUZf8nnGA50D-HkFooNlmkoBJeKYfJxigefcnpCHo0wJff0fl6Q6_fvPu8_VFefLj_u315VRvE6V9oO0naC1UYay6FruNTjoJwaQHUj41JJENLBYFsLslPcNpoPptHQCtkoIy_Iy813wfhtLSH62SfjpqkkimvqeVPL8uOSqYK--Ae9iSuGkq5QgjEhlWoLxTfKYEwJ3dgv6GfAY89Zfyqv38rrS3n9qbz-pHl-77wOs7N_FL_bKoDYgFSuwsHhX0__1_UnbwGong</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1720023448</pqid></control><display><type>article</type><title>Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Peters, Cheryl ; Schwarz, Stephan K. W. ; Yarnold, Cynthia H. ; Kojic, Katarina ; Kojic, Stefan ; Head, Stephen J.</creator><creatorcontrib>Peters, Cheryl ; Schwarz, Stephan K. W. ; Yarnold, Cynthia H. ; Kojic, Katarina ; Kojic, Stefan ; Head, Stephen J.</creatorcontrib><description>Purpose
The use of ultrasound (US) for radial arterial catheterization has been reported to result in faster insertion times with fewer complications when compared with traditional direct palpation (DP). We sought to determine if this applies to expert operators and tested the hypothesis that, among cardiac anesthesiologists, US-guided insertion similarly results in faster insertion times as well as fewer re-directs, attempts, and complications.
Methods
Following Research Ethics Board Approval, we conducted a randomized clinical trial in 125 patients scheduled for cardiac surgery at a single tertiary/quaternary care centre. Patients were randomized to either US- or DP-guided radial artery catheterization by attending cardiac anesthesiologists. The primary endpoint was time to catheter placement. Secondary endpoints included the number of attempts and re-directs as well as the failure rate.
Results
There were no differences between the DP- (
n
= 62)
vs
US-guided (
n
= 63) groups in median [interquartile range] time to placement (104 [76–212] sec
vs
104 [68–270] sec, respectively;
P
= 0.66), number of re-directs (2 [0–6]
vs
3 [1–5], respectively;
P
= 0.82), or number of attempts (1 [1–2]
vs
1 [1–2], respectively;
P
= 0.08). The first-attempt success rate was 56.4% in the DP group and 71.4 % in the US group (
P =
0.10). Failure rate and hematoma rate in the DP group were 21.0% and 22.6%, respectively, compared with 12.7% and 11.1% in the US group (
P
= 0.24 and 0.10, respectively).
Conclusions
Among experienced cardiac anesthesiologists, the use of US to facilitate radial arterial catheterization did not affect insertion times, the number of re-directs, or the number of attempts when compared with DP. Ultrasound use had no significant effects on the rates of success on first attempt, failure, or hematoma formation. This trial was registered at
www.clinicaltrials.gov
: NCT02118441.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/s12630-015-0426-8</identifier><identifier>PMID: 26159436</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Anesthesia ; Anesthesiology ; Anesthesiology - methods ; Canada ; Cardiac Surgical Procedures ; Cardiology ; Catheterization, Peripheral - methods ; Catheters ; Critical Care Medicine ; Female ; Hematoma ; Humans ; Intensive ; Intubation ; Male ; Medical personnel ; Medicine ; Medicine & Public Health ; Pain Medicine ; Palpation ; Patients ; Pediatrics ; Physicians ; Pneumology/Respiratory System ; Radial Artery - diagnostic imaging ; Reports of Original Investigations ; Ultrasonic imaging ; Ultrasonography, Interventional ; Veins & arteries</subject><ispartof>Canadian journal of anesthesia, 2015-11, Vol.62 (11), p.1161-1168</ispartof><rights>Canadian Anesthesiologists' Society 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-6db3d9205c3cd1a97136fb4e4ba49f01343a23eabd8da3941d761bc76a82374c3</citedby><cites>FETCH-LOGICAL-c415t-6db3d9205c3cd1a97136fb4e4ba49f01343a23eabd8da3941d761bc76a82374c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12630-015-0426-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12630-015-0426-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26159436$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peters, Cheryl</creatorcontrib><creatorcontrib>Schwarz, Stephan K. W.</creatorcontrib><creatorcontrib>Yarnold, Cynthia H.</creatorcontrib><creatorcontrib>Kojic, Katarina</creatorcontrib><creatorcontrib>Kojic, Stefan</creatorcontrib><creatorcontrib>Head, Stephen J.</creatorcontrib><title>Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anesth/J Can Anesth</addtitle><addtitle>Can J Anaesth</addtitle><description>Purpose
The use of ultrasound (US) for radial arterial catheterization has been reported to result in faster insertion times with fewer complications when compared with traditional direct palpation (DP). We sought to determine if this applies to expert operators and tested the hypothesis that, among cardiac anesthesiologists, US-guided insertion similarly results in faster insertion times as well as fewer re-directs, attempts, and complications.
Methods
Following Research Ethics Board Approval, we conducted a randomized clinical trial in 125 patients scheduled for cardiac surgery at a single tertiary/quaternary care centre. Patients were randomized to either US- or DP-guided radial artery catheterization by attending cardiac anesthesiologists. The primary endpoint was time to catheter placement. Secondary endpoints included the number of attempts and re-directs as well as the failure rate.
Results
There were no differences between the DP- (
n
= 62)
vs
US-guided (
n
= 63) groups in median [interquartile range] time to placement (104 [76–212] sec
vs
104 [68–270] sec, respectively;
P
= 0.66), number of re-directs (2 [0–6]
vs
3 [1–5], respectively;
P
= 0.82), or number of attempts (1 [1–2]
vs
1 [1–2], respectively;
P
= 0.08). The first-attempt success rate was 56.4% in the DP group and 71.4 % in the US group (
P =
0.10). Failure rate and hematoma rate in the DP group were 21.0% and 22.6%, respectively, compared with 12.7% and 11.1% in the US group (
P
= 0.24 and 0.10, respectively).
Conclusions
Among experienced cardiac anesthesiologists, the use of US to facilitate radial arterial catheterization did not affect insertion times, the number of re-directs, or the number of attempts when compared with DP. Ultrasound use had no significant effects on the rates of success on first attempt, failure, or hematoma formation. This trial was registered at
www.clinicaltrials.gov
: NCT02118441.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Anesthesiology - methods</subject><subject>Canada</subject><subject>Cardiac Surgical Procedures</subject><subject>Cardiology</subject><subject>Catheterization, Peripheral - methods</subject><subject>Catheters</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Hematoma</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intubation</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pain Medicine</subject><subject>Palpation</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Pneumology/Respiratory System</subject><subject>Radial Artery - diagnostic imaging</subject><subject>Reports of Original Investigations</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional</subject><subject>Veins & arteries</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU-L1TAUxYMozpvRD-BGAm7cVPOvaetOHjoKA24ccFduk_SZoU3qTTr45sP4Wc2zo4jgJvdCfufkkEPIM85eccaa14kLLVnFeF0xJXTVPiA7rrqydE39kOxYK0WlOftyRs5TumGMtbpuH5MzoXndKal35Mf1lBFSXIOlh9VbCMbRW4dpTdR6dCbTBaYFso-BjhEpgvUwUcDs8EgN5K-ubP5uI4Yjdd8Xh5nGckKOmN5QKKJg4-zvnKUZf8nnGA50D-HkFooNlmkoBJeKYfJxigefcnpCHo0wJff0fl6Q6_fvPu8_VFefLj_u315VRvE6V9oO0naC1UYay6FruNTjoJwaQHUj41JJENLBYFsLslPcNpoPptHQCtkoIy_Iy813wfhtLSH62SfjpqkkimvqeVPL8uOSqYK--Ae9iSuGkq5QgjEhlWoLxTfKYEwJ3dgv6GfAY89Zfyqv38rrS3n9qbz-pHl-77wOs7N_FL_bKoDYgFSuwsHhX0__1_UnbwGong</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Peters, Cheryl</creator><creator>Schwarz, Stephan K. W.</creator><creator>Yarnold, Cynthia H.</creator><creator>Kojic, Katarina</creator><creator>Kojic, Stefan</creator><creator>Head, Stephen J.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20151101</creationdate><title>Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists</title><author>Peters, Cheryl ; Schwarz, Stephan K. W. ; Yarnold, Cynthia H. ; Kojic, Katarina ; Kojic, Stefan ; Head, Stephen J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-6db3d9205c3cd1a97136fb4e4ba49f01343a23eabd8da3941d761bc76a82374c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Anesthesiology - methods</topic><topic>Canada</topic><topic>Cardiac Surgical Procedures</topic><topic>Cardiology</topic><topic>Catheterization, Peripheral - methods</topic><topic>Catheters</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Hematoma</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intubation</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pain Medicine</topic><topic>Palpation</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>Pneumology/Respiratory System</topic><topic>Radial Artery - diagnostic imaging</topic><topic>Reports of Original Investigations</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peters, Cheryl</creatorcontrib><creatorcontrib>Schwarz, Stephan K. W.</creatorcontrib><creatorcontrib>Yarnold, Cynthia H.</creatorcontrib><creatorcontrib>Kojic, Katarina</creatorcontrib><creatorcontrib>Kojic, Stefan</creatorcontrib><creatorcontrib>Head, Stephen J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peters, Cheryl</au><au>Schwarz, Stephan K. W.</au><au>Yarnold, Cynthia H.</au><au>Kojic, Katarina</au><au>Kojic, Stefan</au><au>Head, Stephen J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists</atitle><jtitle>Canadian journal of anesthesia</jtitle><stitle>Can J Anesth/J Can Anesth</stitle><addtitle>Can J Anaesth</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>62</volume><issue>11</issue><spage>1161</spage><epage>1168</epage><pages>1161-1168</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><abstract>Purpose
The use of ultrasound (US) for radial arterial catheterization has been reported to result in faster insertion times with fewer complications when compared with traditional direct palpation (DP). We sought to determine if this applies to expert operators and tested the hypothesis that, among cardiac anesthesiologists, US-guided insertion similarly results in faster insertion times as well as fewer re-directs, attempts, and complications.
Methods
Following Research Ethics Board Approval, we conducted a randomized clinical trial in 125 patients scheduled for cardiac surgery at a single tertiary/quaternary care centre. Patients were randomized to either US- or DP-guided radial artery catheterization by attending cardiac anesthesiologists. The primary endpoint was time to catheter placement. Secondary endpoints included the number of attempts and re-directs as well as the failure rate.
Results
There were no differences between the DP- (
n
= 62)
vs
US-guided (
n
= 63) groups in median [interquartile range] time to placement (104 [76–212] sec
vs
104 [68–270] sec, respectively;
P
= 0.66), number of re-directs (2 [0–6]
vs
3 [1–5], respectively;
P
= 0.82), or number of attempts (1 [1–2]
vs
1 [1–2], respectively;
P
= 0.08). The first-attempt success rate was 56.4% in the DP group and 71.4 % in the US group (
P =
0.10). Failure rate and hematoma rate in the DP group were 21.0% and 22.6%, respectively, compared with 12.7% and 11.1% in the US group (
P
= 0.24 and 0.10, respectively).
Conclusions
Among experienced cardiac anesthesiologists, the use of US to facilitate radial arterial catheterization did not affect insertion times, the number of re-directs, or the number of attempts when compared with DP. Ultrasound use had no significant effects on the rates of success on first attempt, failure, or hematoma formation. This trial was registered at
www.clinicaltrials.gov
: NCT02118441.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26159436</pmid><doi>10.1007/s12630-015-0426-8</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Canadian journal of anesthesia, 2015-11, Vol.62 (11), p.1161-1168 |
| issn | 0832-610X 1496-8975 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Anesthesia Anesthesiology Anesthesiology - methods Canada Cardiac Surgical Procedures Cardiology Catheterization, Peripheral - methods Catheters Critical Care Medicine Female Hematoma Humans Intensive Intubation Male Medical personnel Medicine Medicine & Public Health Pain Medicine Palpation Patients Pediatrics Physicians Pneumology/Respiratory System Radial Artery - diagnostic imaging Reports of Original Investigations Ultrasonic imaging Ultrasonography, Interventional Veins & arteries |
| title | Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists |
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