Ultrasound Assisted Arterial Cannulation in Small Children
- Conditions
- Arterial Cannulation
- Interventions
- Procedure: Palpation MethodProcedure: Ultrasound
- Registration Number
- NCT01742416
- Lead Sponsor
- The Hospital for Sick Children
- Brief Summary
Arterial cannulation is a commonly performed invasive procedure in the operation room, the emergency department, and in the intensive care unit. The indications include the need for continuous blood-pressure monitoring, frequent arterial blood-gas analysis, and repeated blood sampling for laboratory evaluation. This procedure can be challenging even in the best of hands. Traditionally, the artery is located by feeling the pulse of the patient. The pulse may, however be weak or absent in patients with hypotension, edema, obesity or local thrombosis due to previous arterial cannulation in the same location. Furthermore, the catheter may not be passed successfully into the artery, despite apparent good blood return on initial puncture, or hematoma and spasms of the artery may develop after failed attempts, thus making further attempts even more difficult. While ultrasound (US) is being used with increasing frequency for central venous access, fewer clinicians are familiar with US-guided arterial catheterization. The aim of this study is to investigate if ultrasound facilitates arterial cannulation in children ≤24 months compared with the palpation method and to investigate the potential extra costs/savings of introducing the method. This study hypothesizes that the ultrasound method will facilitate arterial cannulation in small children compared with the palpation method.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 40
- Children 24 months or younger
- Children undergoing elective surgical procedures where arterial cannulation is planned by the attending anaesthetist. These procedures include cardiac surgery, craniotomies, cranial vault surgery, and some abdominal procedures.
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Refusal of consent from the parents
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Refusal of participation from the anaesthetist
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Children with anticipated circulatory instability after anaesthesia induction
- Pulmonary hypertension defined as an estimated pulmonary arterial pressure which is greater than or equal to 66% of systemic blood pressure
- Children with severe heart failure (right and/or left)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Palpation Method Palpation Method - Ultrasound Ultrasound -
- Primary Outcome Measures
Name Time Method Number of Attempts Change from baseline to successful cannulation (estimated average of 30 minutes) To measure the number of attempts to cannulate the artery per participant.
- Secondary Outcome Measures
Name Time Method Learning Curve At approximately 4 months To measure the learning curve for each of the participating anaesthetist.
Time to Successful Cannulation Change from baseline to successful cannulation (estimated average of 30 minutes) To measure the difference between the time when the palpating finger touches the skin (palpation group) or the gel is applied to the skin (US group) at the first intended cannulation site and the time when the arterial cannula is correctly in place.
Rate of Success of First Attempt Change from baseline to success of first attempt, when artery is successfully cannulated on first attempt (estimated average of 30 minutes) The rate of success of first attempt to cannulate the artery of each participant.
Number of Attempted Sites Change from baseline to successful cannulation (estimated average of 30 minutes) To measure the total number of attempted sites.
Cost of Procedure Duration of the study (6 months) To measure the estimated cost of the procedure.
Trial Locations
- Locations (1)
The Hospital for Sick Children
🇨🇦Toronto, Ontario, Canada