Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Pediatr Crit Care Med. 2013 Jun;14(5):471-3. doi: 10.1097/PCC.0b013e31828a8657.
To determine whether ultrasound guidance increases the success rates, decreases the complication rates, and shortens the time to successful radial artery catheterization in infants and small children.
Randomized study.
Single university-affiliated hospital.
Infants and children weighing 3-20 kg, undergoing cardiac surgery for congenital heart disease.
We randomly assigned the right and left radial arteries of patients undergoing arterial catheterization to ultrasound-guided technique versus the usual palpation technique.
The primary study endpoints were the rates of successful cannulation at first and within three attempts. The secondary endpoints were time to radial artery identification, number of attempts for successful cannulation, and rate of complications.
Compared with palpation, ultrasound-guided radial artery catheterization was successful in 76.3% versus 35.6% of first attempts and in 94.9% versus 50.8% of arteries after three attempts (both comparisons, p < 0.01). The median time [interquartile range] to identification of the arteries (18.5 seconds [11.25-27.25] vs 30 seconds [17.75-39.5]) was significantly shorter (p < 0.01), the number of attempts [interquartile range] at successful cannulation (1 [1-1] vs 2 [1-2]) was significantly fewer (p < 0.01), and the proportion of hematomas (5.1% vs 25.4%) was significantly lower (p < 0.01) in the ultrasound group than those in the palpation group.
In infants and small children, ultrasound-guided radial artery catheterization was more successful and expeditious than the usual palpation technique.
确定超声引导是否能提高婴儿和幼儿桡动脉置管术的成功率、降低并发症发生率并缩短置管时间。
随机研究。
单所大学附属医院。
体重 3-20 千克、因先天性心脏病行心脏手术的婴儿和儿童。
我们将接受动脉置管术的患者的右侧和左侧桡动脉随机分配至超声引导技术组和常规触诊技术组。
主要研究终点为首次置管和 3 次尝试内的置管成功率。次要终点为桡动脉识别时间、置管成功尝试次数和并发症发生率。
与触诊相比，超声引导桡动脉置管术首次尝试的成功率为 76.3%，高于触诊的 35.6%（均 p<0.01）；3 次尝试后的成功率为 94.9%，高于触诊的 50.8%（均 p<0.01）。动脉识别的中位数[四分位间距]时间（18.5 秒[11.25-27.25]比 30 秒[17.75-39.5]）显著缩短（p<0.01），置管成功的尝试次数[四分位间距]（1[1-1]比 2[1-2]）显著减少（p<0.01），血肿比例（5.1%比 25.4%）显著降低（p<0.01）。
在婴儿和幼儿中，超声引导桡动脉置管术比常规触诊技术更成功、更迅速。
