Ultrasonography
Conditions
Keywords
Catheter, radial artery
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.
Interventions
PROCEDUREIP-DRA vs IP- PRA
Catetherization approach in plane : distal radial artery VS proximal radial artery
Sponsors
University Tunis El Manar
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
15 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Patients admitted in intensive care unit requiring a central venous catheter (CVC)
Exclusion criteria
* 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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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
| Measure | Time frame | Description |
|---|---|---|
| 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 |
| 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. |
Countries
Tunisia
Outcome results
None listed