ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2020 January;86(1):30-7

DOI: 10.23736/S0375-9393.19.13646-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Ultrasound-guided radial artery cannulation using dynamic needle tip positioning versus conventional long-axis in-plane techniques in cardiac surgery patients: a randomized, controlled trial

Karam NAM, Yunseok JEON, Soohyuk YOON, Seok M. KWON, Pyoyoon KANG, Youn Joung CHO, Tae K. KIM ✉

Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea

BACKGROUND: A novel ultrasound imaging technique, dynamic needle tip positioning (DNTP), enables continuous visualization of the needle tip during ultrasound-guided cannulation. The purpose of this study was to compare the rate of successful first-attempt radial artery cannulations between DNTP and the conventional long-axis in-plane (LAX-IP) technique.
METHODS: Adult patients undergoing cardiac surgery requiring radial artery cannulation were included and randomly allocated into either a DNTP or LAX-IP group. Radial artery cannulation was performed by a single experienced practitioner. The primary outcome was the first-attempt success rate of radial artery cannulation. Secondary outcomes included the length of time needed for cannulation and overall incidence of complications.
RESULTS: A total of 136 patients were studied. The first-attempt success rate of cannulation was 94% in the DNTP group (N.=70) and 68% in the LAX-IP group (N.=66; OR 7.70, 95% CI 2.48-24.94, P<0.001). The total procedure time was also shorter in the DNTP group (median [IQR]; 87 [72-108] seconds) versus the LAX-IP group (118 [93-182] seconds; P<0.001). During cannulation, vasospasm occurred less often in the DNTP (4%) group compared to the LAX-IP group (17%; P=0.018).
CONCLUSIONS: The DNTP technique had a greater first-attempt success rate of radial artery cannulation compared to the conventional LAX-IP technique. Also, DNTP required significantly less time for cannulation and had fewer complications.

KEY WORDS: Cardiac surgical procedures; Catheterization; Radial artery; Ultrasonography