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Ultrasound-guided arterial cannulation in infants improves success rate

Published online by Cambridge University Press:  02 March 2006

U. Schwemmer ,
H. A. Arzet ,
H. Trautner ,
S. Rauch ,
N. Roewer  and
C.-A. Greim
U. Schwemmer
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
H. A. Arzet
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
H. Trautner
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
S. Rauch
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
N. Roewer
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
C.-A. Greim
Affiliation:
University of Würzburg, Department of Anaesthesiology, Würzburg, Germany
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Extract

Summary

Background and objective: In small children, the placement of arterial catheters can be technically challenging for even the most experienced anaesthetist. We investigated whether ultrasound imaging would improve the success rate and reduce time demand and complications of radial artery cannulation. Method: In this prospective randomized study, we performed radial artery cannulation in 30 small children (age 40 ± 33 months) using two different techniques for localization of the vessel. In Group 1 (n = 15), the traditional palpation method was used, while in Group 2 (n = 15) cannulation was directed by vascular ultrasound imaging. In addition, we used ultrasound to determine the cross-sectional area of the radial artery with and without dorsiflexion. For statistical analysis, the non-parametric U-test for non-paired data and the Wilcoxon signed rank sum test for paired data were used. Differences were considered significant, when P < 0.05. Results: Ultrasound-guided puncture was successful in all children of Group 2 compared to only 12 of 15 (80%) children in Group 1. Fewer attempts with the imaging technique were required than with the traditional technique (20 vs. 34, P < 0.05). Dorsiflexion significantly reduced the mean cross-sectional area of the artery by 19%. Conclusion: The current pilot study suggests that ultrasound guidance is appropriate for radial artery catheter insertion, sharing many of the benefits of ultrasound-guided central vein catheter insertion.

Keywords

CATHETERIZATION PERIPHERAL, arterialULTRASONOGRAPHY, radial arteryCHILDRENANAESTHESIA GENERAL
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 476 - 480
Copyright
© 2006 European Society of Anaesthesiology

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References

Rhee KH, Berg RA. Antegrade cannulation of radial artery in infants and children. Chest 1995; 107: 182–184.Google Scholar
Aldridge SA, Gupta JM. Peripheral artery cannulation in newborns. J Singapore Paediatr Soc 1992; 34: 11–14.Google Scholar
Moller JC, Reiss I, Schaible T. Vascular access in neonates and infants – indications, routes, techniques and devices, complications. Intensive Care World 1995; 12: 48–53.Google Scholar
Dillon A. Guidance on the use of ultrasound locating devices for placing central venous catheters. 2002; National Institute for Clinical Excellence (NICE Report), 1–9.
Verghese ST, McGill WA, Patel RI, Sell JE, Midgley FM, Ruttimann UE. Ultrasound-guided internal jugular venous cannulation in infants: a prospective comparison with the traditional palpation method. Anesthesiology 1999; 91: 71–77.Google Scholar
Verghese ST, McGill WA, Patel RI, Sell JE, Midgley FM, Ruttimann UE. Comparison of three techniques for internal jugular vein cannulation in infants. Paediatr Anaesth 2000; 10: 505–511.Google Scholar
Trautner H, Greim CA, Arzet H, Schwemmer U, Roewer N. Ultrasound-guided central venous cannulation in neuropaediatric patients to avoid measures causing potential increase in brain pressure. Anaesthesist 2003; 52: 115–119.Google Scholar
Asheim P, Mostad U, Aadahl P. Ultrasound-guided central venous cannulation in infants and children. Acta Anaesthesiol Scand 2002; 46: 390–392.Google Scholar
Donaldson JS, Morello FP, Junewick JJ, O'Donovan JC, Lim-Dunham J. Peripherally inserted central venous catheters: US-guided vascular access in pediatric patients. Radiology 1995; 197: 542–544.Google Scholar
Alderson PJ, Burrows FA, Stemp LI, Holtby HM. Use of ultrasound to evaluate internal jugular vein anatomy and to facilitate central venous cannulation in paediatric patients. Br J Anaesth 1993; 70: 145–148.Google Scholar
Miller RD, Fleisher LA, Johns RA, Savarese JJ, Wiener-Kronish JP, Young WL. Anesthesia. Churchill Livingstone, 2004.
Rhee KH, Berg RA. Antegrade cannulation of radial artery in infants and children. Chest 1995; 107: 182–184.Google Scholar
Cilley RE. Arterial access in infants and children. Semin Pediatr Surg 1992; 1: 174–180.Google Scholar
Sellden H, Nilsson K, Larsson LE, Ekstrom-Jodal B. Radial arterial catheters in children and neonates: a prospective study. Crit Care Med 1987; 15: 1106–1109.Google Scholar
Todres ID, Rogers MC, Shannon DC, Moylan FM, Ryan JF. Percutaneous catheterization of the radial artery in the critically ill neonate. J Pediatr 1975; 87: 273–275.Google Scholar
Randolph AG, Cook DJ, Gonzales CA, Pribble CG. Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature. Crit Care Med 1996; 24: 2053–2058.Google Scholar
Hind D, Calvert N, McWilliams R et al. Ultrasonic locating devices for central venous cannulation: meta-analysis. BMJ 2003; 327: 361.Google Scholar
Keenan SP. Use of ultrasound to place central lines. J Crit Care 2002; 17: 126–137.Google Scholar
Grebenik CR, Boyce A, Sinclair ME, Evans RD, Mason DG, Martin B. NICE guidelines for central venous catheterization in children. Is the evidence base sufficient? Br J Anaesth 2005; 92: 827–830.Google Scholar
Levin PD, Sheinin O, Gozal Y. Use of ultrasound guidance in the insertion of radial artery catheters. Crit Care Med 2003; 31: 481–484.Google Scholar
Pearse RG. Percutaneous catheterisation of the radial artery in newborn babies using transillumination. Arch Dis Child 1978; 53: 549–554.Google Scholar
Pfenninger J, Bernasconi G, Sutter M. Radial artery catheterization by surgical exposure in infants. Intensive Care Med 1982; 8: 139–141.Google Scholar
Fukutome T, Kojiro M, Tanigawa K, Sese A. Doppler-guided “percutaneous” radial artery cannulation in small children. Anesthesiology 1988; 69: 434–435.Google Scholar
Tada T, Amagasa S, Horikawa H. Absence of efficacy of ultrasonic two-way Doppler flow detector in routine percutaneous arterial cannulation. J Anesth 2003; 17: 206–207.Google Scholar
Morray JP, Brandford HG, Barnes LF, Oh SM, Furman EB. Doppler-assisted radial artery cannulation in infants and children. Anesth Analg 1984; 63: 346–348.Google Scholar