Ultrasound guidance for radial artery catheterization: an updated meta-analysis of randomized controlled trials.
Ultrasound guidance for radial artery catheterization: an updated meta-analysis of randomized controlled trials.
复制标题
DOI：
10.1371/journal.pone.0111527
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhou L
中科院分区：
文献类型：
--
作者：
Tang L;Wang F;Li Y;Zhao L;Xi H;Guo Z;Li X;Gao C;Wang J;Zhou L
由于之前的荟萃分析报告称超声引导与桡动脉导管插入术的首次尝试成功率较高相关，因此许多随机对照试验（RCT）报告的结果不一致。本研究的目的是进行更新的荟萃分析，以阐明超声引导在桡动脉导管插入术中的作用。使用特定的检索词对 PubMed、Embase 和 Cochrane 对照试验中央注册库进行系统文献检索。符合条件的研究是比较超声波引导与传统触诊桡动脉导管插入术的随机对照试验。本荟萃分析采用了使用随机效应模型的Mantel-Haenszel方法。纳入了 7 项随机对照试验，涉及 482 名患者。与传统触诊相比，超声引导显着提高了桡动脉置管的首次成功率（RR 1.51，95% CI 1.07~2.14，P = 0.02）。亚组分析表明，当该技术由经验丰富的用户操作、在幼儿和婴儿中进行以及在手术室的选择性手术中进行时，超声引导桡动脉导管插入术的优越性是显着的。此外，超声引导显着降低了平均成功尝试次数（WMD -1.13，95% CI -1.58至-0.69，P<0.00001）、平均成功时间（WMD -74.77s，95% CI -137.89s至-11.64s，P = 0.02）和血肿发生率（RR） 0.17, 95% CI 0.07–0.41, P = 0.0001)。目前的荟萃分析表明，与传统触诊相比，超声引导桡动脉导管插入术具有明显的益处。在将超声引导技术应用于桡动脉插管之前，需要对超声引导技术进行初步培训和熟悉，特别是对于经验不足的操作者。
Since a previous meta-analysis reported that ultrasound guidance was associated with a higher first-attempt success rate in catheterization of the radial artery, a number of randomized controlled trials (RCTs) have reported inconsistent results. The aim of the present study is to conduct an updated meta-analysis to clarify the role of ultrasound guidance for radial artery catheterization. A systematic literature search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted using specific search terms. Eligible studies were RCTs that compared ultrasound guidance with traditional palpation for radial artery catheterization. The Mantel-Haenszel method using the random effects model was adopted in this meta-analysis. Seven RCTs with 482 patients were included. Compared with traditional palpation, ultrasound guidance significantly increased the first-attempt success rate of radial artery catheterization (RR 1.51, 95% CI 1.07–2.14, P = 0.02). Subgroup analyses suggested that the superiority of ultrasound guidance for radial artery catheterization was significant when the technique was operated by experienced users, performed in small children and infants, and on elective procedures in the operating room. In addition, ultrasound guidance significantly reduced mean-attempts to success (WMD −1.13, 95% CI −1.58 to −0.69, P<0.00001), mean-time to success (WMD −74.77s, 95% CI −137.89s to −11.64s, P = 0.02), and the occurrence of hematoma (RR 0.17, 95% CI 0.07–0.41, P = 0.0001). The present meta-analysis suggests a clear benefit from ultrasound guidance for radial artery catheterization compared with the traditional palpation. Preliminary training and familiarization with the ultrasound-guided technique is needed before applying it for radial artery catheterization, especially for inexperienced operators.
登录
查看更多内容
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
2.1
作者：
Hansen, M. A.;Juhl-Olsen, P.;Sloth, E.
通讯作者：
Sloth, E.
影响因子：
3.6
作者：
Bobbia, Xavier;Grandpierre, Romain Genre;de La Coussaye, Jean-Emmanuel
通讯作者：
de La Coussaye, Jean-Emmanuel
影响因子：
38.9
作者：
HACK, WWM;VOS, A;OKKEN, A
通讯作者：
OKKEN, A
影响因子：
5.7
作者：
Troianos, Christopher A.;Hartman, Gregg S.;Reeves, Scott T.
通讯作者：
Reeves, Scott T.