DRA vs PRA for US-guided Radial Artery Catheterization in ICU
- Conditions
- Ultrasonography
- Interventions
- Procedure: IP-DRA vs IP- PRA
- Registration Number
- NCT04878887
- Lead Sponsor
- University Tunis El Manar
- Brief Summary
Patients were randomly divided into two groups: ultrasound-guided (US-guided) in-plane distal radial access (IP-DRA) and in-plane proximal radial access (IP-PRA) catheterization.
For IP-DRA , a linear transducer is placed in the radial fossa, which is known as the snuff-box. After obtaining a long-axis view of the radial artery ,the needle is inserted in the midpoint of the small footprint transducer. Then,the needle is advanced under real-time US guidance until visualizing the tip of the needle inside the artery .
For IP-PRA , a linear transducer is placed in the standard conventional forearm radial.
After obtaining a long-axis view of the radial artery ,the needle is inserted in the midpoint of the small footprint transducer. Then,the needle is advanced under real-time US guidance until visualizing the tip of the needle inside the artery .
- Detailed Description
\*Ultrasound-guided catheterization of the radial artery, by proximal approach:
* Patient's hand in hyperextension with slight dorsiflexion of the wrist.
* The placement of the ultrasound probe initially linear in order to obtain the "short axis" image of the artery; then a quarter turn until obtaining a longitudinal "long axis" view.
* The operator must identify the artery using the pulsed wave Doppler;
* Insertion of the needle in the middle of the transducer providing an "in plane" orientation. Thus the needle was advanced slowly and its tip was visualized throughout the procedure. \*Ultrasound-guided catheterization of the radial artery, by distal approach:
* If the right hand is along the body / if the left hand is on the trunk.
* The ultrasound probe placed at the level of the anatomical snuffbox by placing the transducer in a linear fashion then rotated coronally until a longitudinal image is obtained \*In the 2 groups: - The longitudinal "in plane" approach is used - After visualization of the penetration of the bevel of the needle into the lumen of the artery and the jet of arterial blood into the syringe on aspiration, a flexible metal guide was introduced into the artery through the trocar according to the Seldinger's method. - The correct positioning of the guide in the artery was then confirmed by ultrasound. Any obstacle preventing insertion of the guide system always led to a new puncture.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 94
- Patients admitted in intensive care unit requiring a central venous catheter (CVC)
- Patients with radial AV shunt for hemodialysis
- Patients with Renaud phenomenon or lymphedema
- Congenital or acquired deformity of arms
- Cannulation site infection, hematoma and surgery
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description IP-DRA IP-DRA vs IP- PRA In plane distal radial artery catherterization IP-PRA IP-DRA vs IP- PRA In plane proximal radial artery catherterization
- Primary Outcome Measures
Name Time Method The overall access time During the cannulation procedure Time from the ultrasound scanning to the ultrasound confirmation of the correct position of the guidewire .
- Secondary Outcome Measures
Name Time Method 5. Rare complications After 01 weeks of the procedure. Pseudo-aneurysm, AV fistula formation, radial artery dissection, which are assessed by Doppler US. In addition to radial artery eversion or perforation.
2. Puncture Attempts During the procedure Which is the number of puncture attempts from first one until the successful one
3. The guidewire time during the procedure Time from the first skin puncture to the ultrasound confirmation of the correct placement of the guidewire
4. The access time during the procedure time between the first skin puncture and the jet of arterial blood
Trial Locations
- Locations (1)
Mrezga Nabeul Tunisie
🇹🇳Nabeul, Tunisia