Ultrasound guidance for radial arterial puncture: a randomized controlled trial
Ultrasound guidance for radial arterial puncture: a randomized controlled trial
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DOI：
10.1016/j.ajem.2013.01.029
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发表时间：
2013-05-01
影响因子：
3.6
通讯作者：
de La Coussaye, Jean-Emmanuel
中科院分区：
文献类型：
--
作者：
Bobbia, Xavier;Grandpierre, Romain Genre;de La Coussaye, Jean-Emmanuel
研究目的和背景：动脉穿刺法进行血气分析是一项频繁的操作，在急诊情况下可能会遇到困难。本研究的目的是比较超声引导下的动脉放射状穿刺术和常规取材。材料和方法：这是一项前瞻性的随机研究。纳入标准是所有在急诊室入院时需要动脉血气的患者。排除标准如下：Hallen试验阳性，局部败血症，局部创伤，已知严重局部动脉病变，患者拒绝同意，参与另一项研究，以及心脏骤停。将患者随机分为两组：超声引导下经桡动脉穿刺组(第1组)和常规方法穿刺组(第2组)。主要目标是注册后的尝试次数。次要目标是成功的时间、患者的满意度和痛苦以及医生的满意度。收集即时并发症。组间比较采用非参数分析。结果：74例患者中有72例数据可用。肺部疾病(慢性阻塞性肺疾病急性加重和肺炎)占45%(n=32)，可疑肺栓塞占31%(n=22)。人口统计学数据在两组中具有可比性。在第一组中，尝试次数显著增加(2.35[1-3]vs 1.66[1-2][P=.017])，样本长2.4倍(标准方法为132秒[50-200]vs 55[20-65][P<；0.01])。两组在疼痛(视觉模拟评分[VAS]，3.6[2-5]，P=.743])、患者满意度(VAS，7.2[5-9]比6.8[5-9][P=.494])和医生满意度(VAS，6.0[3.5-8]比6.9[5-9][P=.233])方面没有显著差异。两组均未发现即刻并发症。结论：超声引导下动脉穿刺术增加了实施次数和持续时间。然而，这种技术不会改变患者的疼痛、即时并发症的数量，也不会改变患者和医生的满意度。(C)2013 Elsevier Inc.保留所有权利。
Study Objective and Background: Arterial puncture for blood gas analysis is a frequent procedure and could be difficult in the emergency setting. The aim of the study was to compare ultrasonographically guided arterial radial puncture vs conventional sampling.Materials and Methods: This is a prospective, randomized study. The inclusion criteria are all patients needing arterial blood gas at admission in the emergency unit. The exclusion criteria are the following: Hallen test positive, local sepsis, local trauma, known sever local arteriopathy, refusal of consent by the patient, participation in another study, and cardiac arrest. Patients were randomized into 2 groups: radial arterial puncture obtained through an ultrasonographically guided technique (group 1) or radial arterial puncture by conventional method (group 2). The main objective is the number of attempts after enrollment. The secondary objectives are time to success, patient satisfaction and pain, and physician satisfaction. Immediate complications were collected. Groups were compared with nonparametric analysis.Results: The data were usable for 72 of 74 patients included. Lung disease (acute exacerbation of chronic obstructive pulmonary disease and pneumonia) at 45% (n = 32) and suspicion of pulmonary embolism in 31% (n = 22) were the most common reasons. Demographics data were comparable in the 2 groups. In group 1, the number of attempts significantly increased (2.35 [1-3] vs 1.66 [1-2] [P = .017]), and the sample was 2.4 times longer (132 seconds [50-200] vs 55 [20-65] [P < .01] by standard method). There was no significant difference in terms of pain (visual analog scale [VAS], 3.6 [2-5] for both groups [P = .743]), patient satisfaction (VAS, 7.2 [5-9] vs 6.8 [5-9] [ P = .494]), and physician satisfaction (VAS, 6.0 [3.5-8] vs 6.9 [5-9] [P = .233]). No immediate complications were found in the 2 groups.Conclusion: Ultrasonographically guided arterial puncture increases the number and duration of implementations. This technique, however, does not alter the patient's pain, the number of immediate complications, or patient and physician satisfaction. (c) 2013 Elsevier Inc. All rights reserved.