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儿童桡动脉置管改良长轴平面内技术:一项随机对照试验

Modified Long-Axis In-plane Technique for Radial Artery Cannulation in Children: A Randomized Controlled Trial.

作者信息

Yu Liu, Zhong Heying, Jiang Yan, Zhang Wangping, Liu Zhiwei

机构信息

Department of Anesthesiology, Women and Children's Hospital of Jiaxing University, Jiaxing, China.

Department of Anesthesiology, Huadu District People's Hospital, Southern Medical University, Guangzhou, China.

出版信息

Front Med (Lausanne). 2022 Feb 7;8:780375. doi: 10.3389/fmed.2021.780375. eCollection 2021.

DOI:10.3389/fmed.2021.780375
PMID:35211482
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8862683/
Abstract

BACKGROUND

Radial artery catheterization is a challenge for anesthetists in the pediatric population. The purpose of this study was to determine whether the modified long-axis in-plane (MLAX-IP) technique increased the success rate of radial artery catheterization in children.

METHODS

This study involved 80 children who required arterial catheterization and were randomly divided into the MLAX-IP group and dynamic needle tip positioning (DNTP) group (40 cases in each group). Radial artery catheterization was performed using either the MLAX-IP technique or the DNTP technique.

RESULTS

The first-attempt cannulation success rate was higher in the MLAX-IP group than in the DNTP group (95 vs. 80%, = 0.043). The imaging time of the artery in the MLAX-IP group was longer than in the DNTP group (19.1 ± 3.1 vs. 9.6 ± 2.4 s, < 0.001). While the total catheterization time was similar between the 2 groups (88.1 ± 23 vs. 86.9 ± 46.1 s, = 0.475).

CONCLUSION

The first-attempt cannulation success rate with the MLAX-IP technique is increased, while the total catheterization time is similar between the 2 groups and puncture-related complications are fewer.

摘要

背景

桡动脉置管对儿科麻醉医生来说是一项挑战。本研究的目的是确定改良长轴平面内(MLAX - IP)技术是否能提高儿童桡动脉置管的成功率。

方法

本研究纳入80例需要进行动脉置管的儿童,随机分为MLAX - IP组和动态针尖定位(DNTP)组(每组40例)。分别采用MLAX - IP技术或DNTP技术进行桡动脉置管。

结果

MLAX - IP组首次穿刺成功率高于DNTP组(95%对80%,P = 0.043)。MLAX - IP组动脉成像时间长于DNTP组(19.1±3.1秒对9.6±2.4秒,P < 0.001)。而两组的总置管时间相似(88.1±23秒对86.9±46.1秒,P = 0.475)。

结论

MLAX - IP技术提高了首次穿刺成功率,两组总置管时间相似且穿刺相关并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0665/8862683/3e71be08eba6/fmed-08-780375-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0665/8862683/39383d2c151d/fmed-08-780375-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0665/8862683/3e71be08eba6/fmed-08-780375-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0665/8862683/39383d2c151d/fmed-08-780375-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0665/8862683/3e71be08eba6/fmed-08-780375-g0002.jpg

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J Cardiothorac Vasc Anesth. 2022 Mar;36(3):677-683. doi: 10.1053/j.jvca.2021.05.036. Epub 2021 May 24.
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Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials.超声引导技术在儿科人群桡动脉置管中的有效性:系统评价和随机对照试验的荟萃分析。
Crit Care. 2020 May 6;24(1):197. doi: 10.1186/s13054-020-02920-8.
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超声引导下动脉置管的长轴平面内与短轴平面外入路的比较:一项荟萃分析和系统评价。
BMC Anesthesiol. 2023 Apr 13;23(1):120. doi: 10.1186/s12871-023-02076-2.
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Ultrasound-Guided Dynamic Needle-Tip Positioning Method Is Superior to Conventional Palpation and Ultrasound Method in Arterial Catheterization.超声引导下动态针尖定位法在动脉导管插入术中优于传统触诊法和超声法。
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