Numaguchi Atsushi, Adachi Yushi U, Aoki Yoshitaka, Ishii Yasuhiro, Suzuki Katsumi, Obata Yukako, Sato Shigehito, Nishiwaki Kimitoshi, Matsuda Naoyuki
Department of Emergency Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, 4668550, Japan.
Department of Pediatrics, Developmental Pediatrics, Nagoya Graduate School of Medicine, Nagoya, Japan.
J Clin Monit Comput. 2015 Oct;29(5):653-7. doi: 10.1007/s10877-014-9648-5. Epub 2014 Dec 16.
Radial arterial cannulation is a popular technique for continuous hemodynamic monitoring in an area of anesthesia and intensive care. Although the risk for invasive monitoring is considerable, there is scarce information about the change in blood flow of cannulated vessel after the catheterization. In the current investigation, we evaluated the change in the cannulated arterial blood flow. Six volunteers (study 1) and eight post-surgical patients (study 2) were enrolled into the studies. In the study 1, the both side of diameter of radial artery (RA), ulnar artery (UA) and dorsal branch of radial artery (DBRA) of participants were measured using power Doppler ultrasound (PDU) with or without proximal oppression. In the study 2, the diameter of RA, UA and DBRA of the both intact and cannulated side were compared. Study 1: The diameter of RA was 3.4 (0.52) [mean (SD)] mm and the proximal oppression significantly decreased the diameter to 1.8 (0.59) mm. The diameter of DBRA measured by PDU also decreased 2.0 (0.60)-1.3 (0.59) mm. Study 2: There was no difference between the diameters of right and left RA, however, the UA was larger [3.4 (0.60) vs. 2.8 (0.83) mm] and the DBRA was narrower [1.4 (0.43) vs. 2.0 (0.47) mm] in the cannulated side. The diameters of DBRA were different between the intact and cannulated side in the patients. Although there is no information of relationships between cause of severe complication and decreased flow, significant reduction of blood flow should be concerned.
桡动脉置管是麻醉和重症监护领域中用于连续血流动力学监测的常用技术。尽管侵入性监测的风险相当大,但关于置管后血管血流变化的信息却很少。在本研究中,我们评估了置管动脉血流的变化。六名志愿者(研究1)和八名术后患者(研究2)被纳入研究。在研究1中,使用功率多普勒超声(PDU)测量参与者桡动脉(RA)、尺动脉(UA)和桡动脉背支(DBRA)两侧的直径,测量时有无近端压迫。在研究2中,比较了完整侧和置管侧的RA、UA和DBRA的直径。研究1:RA的直径为3.4(0.52)[平均值(标准差)]mm,近端压迫使直径显著减小至1.8(0.59)mm。通过PDU测量的DBRA直径也从2.0(0.60)mm减小至1.3(0.59)mm。研究2:左右RA的直径之间没有差异,然而,置管侧的UA更大[3.4(0.60)对2.8(0.83)mm],DBRA更窄[1.4(0.43)对2.0(0.47)mm]。患者中完整侧和置管侧的DBRA直径不同。尽管没有关于严重并发症原因与血流减少之间关系的信息,但血流的显著减少仍应引起关注。