Randomized Trial of Ultrasound-guided Radial Artery Cannulation Using Dynamic Short Axis Versus Conventional Long-axis In-plane View in Cardiac Surgery Patients.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 146
- 试验地点
- 2
- 主要终点
- Success rate of the radial artery cannulation at first attempt
研究概览
简要总结
When performing vascular cannulation such as radial artery cannulation, ultrasonography (US) helps proper positioning of the tip of needle in the vascular lumen, which facilitating cannulation of the catheter and successful pressure monitoring. Conventionally, short-axis out-of-plane (SAX) and long-axis in-plane (LAX) views are commonly used method to image the target vessel during cannulation under US guidance. Dynamic needle tip positioning (DNTP) method is newly introduced by one group of investigators who conducted a related study using vascular phantom model.
In DNTP, SAX is used, and additionally, when the needle tip is imaged in the screen as an echogenic point, the practitioner (a) proximally moves the US probe a bit, and then (b) the needle is advanced until the needle tip reappears in the screen. In this manner, the practitioner repeats (a) and (b) until the needle is inserted 1 cm into the lumen of vessel, and then the catheter is inserted to finish the procedure.
DNTP has not been compared to conventional imaging methods. The aim of this trial is to see the effect of DNTP on success rate of the radial artery cannulation at the first attempt, compared to the conventional LAX.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- Triple (Participant, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 19 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Elective cardiovascular surgery where RA catheterization is newly required.
排除标准
- •skin infection or trauma
- •Bilateral arteriovenous fistula for dialysis
- •Severe peripheral vascular disease
- •Severe arteriosclerosis or arterial atheroma
- •Raynaud disease
- •Patients on ECMO or IABP support
- •Morbid obesity
- •Profound coagulopathy
- •Negative results of modified Allen's test
研究组 & 干预措施
Dynamic needle tip positioning
In DNTP, SAX is used, and additionally, when the needle tip is imaged in the screen as an hyper-echoic point, the practitioner (a) moves the US probe proximally a bit, and (b) the needle is advanced until the needle tip reappears in the screen. In this manner, the practitioner repeats (a) and (b) until the needle is inserted 1 cm into the lumen of vessel, and then the catheter is inserted to finish the procedure.
干预措施: Dynamic needle tip positioning under ultrasound-guidance (Procedure)
Conventional long-axis
干预措施: Conventional long-axis view (Procedure)
结局指标
主要结局
Success rate of the radial artery cannulation at first attempt
时间窗: intraoperative
Successful confirmation of the arterial waveform through a pressure monitor at first attempt of the radial artery cannulation
次要结局
- Time between skin puncture to confirmation of the arterial waveform through a pressure monitoring device.(During the cannulation procedure.)
研究者
Tae Kyong Kim
Clinical Assistant Professor
Seoul National University Hospital
