Kumar Lakshmi, Subramaniam Rajasri, Kartha P Anandajith, Thomas Dimple E, Patel Sunil, Kartha Niveditha
Department of Anesthesiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Department of Radiology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Indian J Anaesth. 2024 Oct;68(10):909-914. doi: 10.4103/ija.ija_628_24. Epub 2024 Sep 14.
To evaluate the flow at the cannulation site in the radial artery, the resistive indices (RIs) before cannula insertion and 6 h after decannulation were measured (primary outcome). The secondary outcomes were measurement of the artery size by anteroposterior (AP) diameter at the insertion site, RI and AP diameter at a point 4 cm proximal and in the ipsilateral ulnar artery before insertion and 6 h after cannula removal.
In 96 patients requiring an arterial line during surgery, peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured to derive RI using a linear ultrasound transducer. The RI was measured at R1 (insertion point), R2, 4 cm proximal to R1, and U1 on the ipsilateral ulnar artery. The AP diameter of the arteries at baseline R1, R2 and U1 was measured and repeated 6 h after removal of the cannula, R1, R2 and U1.
RI or AP diameter in R1 or R2 did not differ pre- and post-cannulation. Mean R1 1.143 [standard deviation (SD: 0.239)] versus R1 1.181 (SD: 0.260) m/sec [mean difference (MD): -0.0372 (95% confidence interval (CI): -0.098, 0.023), = 0.230]. Mean AP diameter at baseline versus 6 h decannulation 0.177 (SD: 0.042) versus 0.172 (SD: 0.045) cm [MD: 0.005 (95% CI: 0.003, 0.013), = 0.222] was also similar. The mean PSV in U1 versus U1 was higher: 0.480 (SD: 0.178) versus 0.528 (SD: 0.316) m/sec [MD: 0.120 (95% CI: -0.185, -0.054), = 0.002] and AP diameter was also higher than baseline ( = 0.001).
The flow in the radial artery did not change following cannulation. The PSV and AP diameter in the ulnar artery increased after decannulation, suggesting a compensatory increase in flow.
为评估桡动脉置管部位的血流情况，测量了置管前及拔管后6小时的阻力指数（RI）（主要结局指标）。次要结局指标包括通过测量置管部位的前后径（AP）来评估动脉大小，以及测量置管前和拔管后6小时在置管点近端4 cm处和同侧尺动脉的RI和AP直径。
对96例手术中需要动脉置管的患者，使用线性超声换能器测量收缩期峰值流速（PSV）和舒张末期流速（EDV）以得出RI。在R1（置管点）、R2（R1近端4 cm处）以及同侧尺动脉的U1处测量RI。测量置管前及拔管后6小时在R1、R2和U1处动脉的AP直径。
置管前后R1或R2处的RI或AP直径无差异。R1处平均流速1.143 [标准差（SD）：0.239] 与R1处1.181（SD：0.260）m/秒 [平均差值（MD）：-0.0372（95%置信区间（CI）：-0.098，0.023），P = 0.230]。置管前与拔管后6小时的平均AP直径分别为0.177（SD：0.042）与0.172（SD：0.045）cm [MD：0.005（95% CI：0.003，0.013），P = 0.222]，也相似。U1处的平均PSV与U1处相比更高：0.480（SD：0.178）与0.528（SD：0.316）m/秒 [MD：0.120（95% CI：-0.185，-0.054），P = 0.002]，且AP直径也高于基线（P = 0.001）。
桡动脉置管后血流未发生改变。拔管后尺动脉的PSV和AP直径增加，提示血流出现代偿性增加。
