Ultrasound visual image-guided vs Doppler auditory-assisted radial artery cannulation in infants and small children by non-expert anaesthesiologists: a randomized prospective study
Ultrasound visual image-guided vs Doppler auditory-assisted radial artery cannulation in infants and small children by non-expert anaesthesiologists: a randomized prospective study
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DOI：
10.1093/bja/aes383
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发表时间：
2013-02-01
影响因子：
9.8
通讯作者：
Bayman, E. O.
中科院分区：
文献类型：
--
作者：
Ueda, K.;Puangsuvan, S.;Bayman, E. O.
即使对于最有经验的提供者来说，对婴儿和幼儿进行桡动脉插管也可能具有挑战性。利用多普勒来辅助桡动脉插管已被充分描述。最近的研究证明了超声（US）图像引导血管通路技术在儿科人群中的有效性。尚未研究非专家人员使用这两种技术的效用。这是一项随机前瞻性研究，旨在比较两种不同的桡动脉插管技术在体重 12 kg 的儿科患者中的效用：超声引导技术（美国组）与多普勒辅助技术（多普勒组），由经验有限的受训者使用。主要目标是比较每组之间的首次尝试成功率。作为次要目标，比较 10 分钟内的成功率。在 50 名儿科患者 (n104) 被纳入研究并且每组 52 名被随机分配到超声组或多普勒组后，试验提前终止。共有 12 名麻醉实习生进行了桡动脉插管。与多普勒组相比，美国组的首次尝试成功率更高[17/52（33）vs 8/52（15），P0.039，比值比（OR）：2.67，置信区间（CI）：1.036.91]。超声组10分钟内的总体成功率为34/52（65），多普勒组为24/52（46）（P0.048，OR：2.20，CI：1.004.85）。与多普勒辅助技术相比，超声引导婴儿和幼儿的桡动脉插管首次尝试成功的机会更大。
Cannulation of the radial artery in infants and small children can be challenging, even for the most experienced providers. Utilizing Doppler to aid in radial artery cannulation has been well described. Recent studies have demonstrated the efficacy of ultrasound (US) image-guided vascular access techniques in the paediatric population. The utility of these two techniques, when used by non-expert personnel, has not been studied.This is a randomized prospective study to compare the utility of two different radial arterial cannulation techniques in paediatric patients weighing 12 kg: US-guided technique (US group) vs Doppler-assisted technique (Doppler group) when used by trainees with limited experience. The primary objective was to compare the first-attempt success rate between each group. As a secondary objective, success rate within 10 min was compared.The trial was prematurely terminated after 50 of paediatric patients (n104) were included in the study and 52 of each were randomized to the US or Doppler group. A total of 12 anaesthesia trainees performed radial arterial cannulations. The first-attempt success rate was greater in the US group compared with the Doppler group [17/52 (33) vs 8/52 (15), P0.039, odds ratio (OR): 2.67, confidence interval (CI): 1.036.91]. The overall success rate within 10 min was 34/52 (65) in the US group and 24/52 (46) in the Doppler group (P0.048, OR: 2.20, CI: 1.004.85).US-guided radial arterial cannulation in infants and small children provided a greater chance for success at the first attempt compared with the Doppler-assisted technique.