A Comparison of Ultrasound-Guided Versus Direct Palpation For Radial Artery Catheterization Among Cardiac Anesthesiologists
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 129
- Locations
- 1
- Primary Endpoint
- Time to Successful Radial Arterial Catheterization
Study Overview
Brief Summary
When a patient undergoes heart surgery, their Anesthesiologist will insert a tiny plastic tube, called a catheter, in the artery of the patient's wrist. This is called a radial artery catheter. A radial artery catheter allows accurate measurement of the patient's blood pressure during surgery. There are two common techniques for placing the radial artery catheter. The first is a "blind" technique whereby the Anesthesiologist feels for the pulse in the patient's wrist and places the catheter using the location of the pulse as a guide. The second technique, less commonly used, is one whereby the Anesthesiologist uses an ultrasound machine (painless to the patient) to "see" the artery, and thereby uses the ultrasound to guide the catheter placement. Our study will test the hypothesis that ultrasound-guided radial artery catheterization will have faster insertion times, with fewer complications compared with palpation-guided insertion.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 19 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Patients undergoing cardiac surgery
- •Age 19 or older
- •Provided written informed consent
Exclusion Criteria
- •Suspected inability to comply with study procedures, including language difficulties or medical history and/or concomitant disease, as judged by the investigator
- •Previous surgery at the site of proposed radial artery catheterization
- •Any vascular condition that may preclude eligibility for radial artery line insertion as judged by the investigator
- •Patients with ventricular assist devices
- •Previous inclusion in this study
Arms & Interventions
direct palpation
Radial artery catheter insertion will be conducted by direct palpation and use of anatomic knowledge by the Anesthesiologist.
Intervention: Direct Palpation-guided Radial Artery Catheter insertion (Device)
Ultrasound
Radial artery catheter insertion will be conducted by ultrasound guidance. A Sono-site ilook 25 Ultrasound (Sono-site, Inc., Bothell, WA, USA) with a 10-5 MHz linear array ultrasound transducer will be used.
At the discretion on the Anesthesiologist, an out-of-plane (i.e. needle plane at right angles to ultrasound plane) will be used. Colour flow doppler may also be used to identify the artery if necessary.
Intervention: Ultrasound-guided Radial Artery Catheter Insertion (Device)
Outcomes
Primary Outcomes
Time to Successful Radial Arterial Catheterization
Time Frame: up to 5 minutes
The time to successful radial arterial catheterization was defined as time zero to time of placement. Time zero for the DP group began when the anesthesiologist's fingers were placed on the patient with the purpose of palpating the artery. Time zero for the US group began when the US transducer was first placed on the patient's skin for the purpose of identifying the radial artery. Time to placement was defined as the interval from time zero until the time at which an arterial tracing was viewed on the monitor.
Secondary Outcomes
- Number of Attempts(up to 5 minutes)
- Complication Rate (Hematoma)(up to 5 minutes)
- Number of Re-directions(up to 5 minutes)