Randomized Trial of Ultrasound-guided Radial Artery Cannulation Using Dynamic Short Axis Versus Conventional Long-axis In-plane View in Cardiac Surgery Patients.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 146
- Locations
- 1
- Primary Endpoint
- Success rate of the radial artery cannulation at first attempt
Study Overview
Brief Summary
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- Triple (Participant, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 19 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Elective cardiovascular surgery where RA catheterization is newly required.
Exclusion Criteria
- •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
Arms & Interventions
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.
Intervention: Dynamic needle tip positioning under ultrasound-guidance (Procedure)
Conventional long-axis
Intervention: Conventional long-axis view (Procedure)
Outcomes
Primary Outcomes
Success rate of the radial artery cannulation at first attempt
Time Frame: intraoperative
Successful confirmation of the arterial waveform through a pressure monitor at first attempt of the radial artery cannulation
Secondary Outcomes
- Time between skin puncture to confirmation of the arterial waveform through a pressure monitoring device.(During the cannulation procedure.)
Investigators
Tae Kyong Kim
Clinical Assistant Professor
Seoul National University Hospital