Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Anaesth Crit Care Pain Med. 2023 Apr;42(2):101166. doi: 10.1016/j.accpm.2022.101166. Epub 2022 Oct 25.
Arterial catheterization is challenging in obese patients. The present study tested the hypothesis that ultrasound guidance with acoustic shadowing improves the success rate of radial artery catheterization in obese patients.
240 obese patients were enrolled and were randomly assigned to three groups: control group, single developing line group, or double developing lines group. Patients underwent radial artery catheterization guided by acoustic shadowing ultrasound with none, single or double developing lines. The primary outcome was the first-attempt success rate. The secondary outcomes included the procedure time and complication rate.
In the single or double developing lines group, the success rate of radial artery catheterization at the first attempt was higher than in the control group (control vs. single vs. double, 71% vs. 90% vs. 91%, P = 0.001). Besides, the single and double developing lines groups had a shorter procedure time to success at the first attempt and a lower overall complication (vasospasm and hematoma) rate than the control group (procedure time: control vs. single vs. double, 63 s vs. 54 s vs. 40 s, P < 0.001; overall complication rate: control vs. single vs. double, 29% vs. 10% vs. 9%, P = 0.001). There was no significant difference in the first-attempt success rate, the procedure time to success within the first attempt, or overall complications' rate between the single and double developing lines groups.
Single and double developing lines improve first-attempt success rate and reduced the overall complications' rate of ultrasound-guided radial artery catheterization in obese patients.
在肥胖患者中进行动脉置管具有挑战性。本研究检验了这样一个假设，即超声引导下的声影可提高肥胖患者桡动脉置管的首次成功率。
纳入 240 例肥胖患者，并将其随机分为三组：对照组、单发展线组和双发展线组。患者在超声引导下行桡动脉置管，分别采用无、单、双发展线。主要结局为首次尝试成功率。次要结局包括操作时间和并发症发生率。
在单或双发展线组中，桡动脉置管的首次尝试成功率高于对照组（对照组、单发展线组和双发展线组分别为 71%、90%和 91%，P=0.001）。此外，单发展线组和双发展线组首次尝试成功的操作时间更短，且总并发症（血管痉挛和血肿）发生率更低（操作时间：对照组、单发展线组和双发展线组分别为 63s、54s 和 40s，P<0.001；总并发症发生率：对照组、单发展线组和双发展线组分别为 29%、10%和 9%，P=0.001）。单发展线组和双发展线组之间首次尝试成功率、首次尝试成功的操作时间或总并发症发生率无显著差异。
在肥胖患者中，单发展线和双发展线均可提高超声引导下桡动脉置管的首次成功率，并降低总并发症发生率。
