Johns Hopkins Hospital, Department of Emergency Medicine, Baltimore, Maryland.
West J Emerg Med. 2020 Feb 26;21(2):353-358. doi: 10.5811/westjem.2019.12.44583.
We sought to determine whether ultrasound-guided arterial cannulation (USGAC) is more successful than traditional radial artery cannulation (AC) as performed by emergency medicine (EM) residents with standard ultrasound training.
We identified 60 patients age 18 years or older at a tertiary care, urban academic emergency department who required radial AC for either continuous blood pressure monitoring or frequent blood draws. Patients were randomized to receive radial AC via either USGAC or traditional AC. If there were three unsuccessful attempts, patients were crossed over to the alternative technique. All EM residents underwent standardized, general ultrasound training.
The USGAC group required fewer attempts as compared to the traditional AC group (mean 1.3 and 2.0, respectively; p<0.001); 29 out of 30 (96%) successful radial arterial lines were placed using USGAC, whereas 14 out of 30 (47%) successful lines were placed using traditional AC (p<0.001). There was no significant difference in length of procedure or complication rate between the two groups. There was no difference in provider experience with respect to USGAC vs traditional AC.
EM residents were more successful and had fewer cannulation attempts with USGAC when compared to traditional AC after standard, intern-level ultrasound training.
我们旨在确定经过标准超声培训的急诊医学（EM）住院医师进行超声引导动脉置管术（USGAC）是否比传统的桡动脉置管术（AC）更成功。
我们在一家三级保健、城市学术急诊部门确定了 60 名年龄在 18 岁或以上的患者，这些患者需要进行桡动脉置管术以进行连续血压监测或频繁采血。患者被随机分为 USGAC 或传统 AC 组接受桡动脉置管术。如果三次尝试均不成功，则患者将交叉到另一种技术。所有 EM 住院医师都接受了标准化的一般超声培训。
与传统 AC 组相比，USGAC 组所需的尝试次数更少（分别为 1.3 和 2.0；p<0.001）；29 例中的 30 例（96%）使用 USGAC 成功放置桡动脉导管，而 30 例中的 14 例（47%）使用传统 AC 成功放置（p<0.001）。两组之间的手术时间或并发症发生率没有差异。两组之间的 USGAC 与传统 AC 的提供者经验没有差异。
在标准的、住院医师水平的超声培训后，与传统 AC 相比，EM 住院医师使用 USGAC 时成功率更高，置管尝试次数更少。
