Dynamic SAX vs Conventional LAX in Radial Artery Cannulation.

Seoul National University

Status: Completed

Conditions: Ultrasonography; Cardiac Surgical Procedures; Catheterization

Treatments: Procedure: Dynamic needle tip positioning under ultrasound-guidance; Procedure: Conventional long-axis view

Study type: Interventional

Funder types: Other

Identifiers

NCT03405623

DNTP vs LAX

Details and patient eligibility

About

When performing vascular cannulation such as radial artery cannulation, ultrasonography (US) helps proper positioning of the tip of needle in the vascular lumen, which facilitating cannulation of the catheter and successful pressure monitoring. Conventionally, short-axis out-of-plane (SAX) and long-axis in-plane (LAX) views are commonly used method to image the target vessel during cannulation under US guidance. Dynamic needle tip positioning (DNTP) method is newly introduced by one group of investigators who conducted a related study using vascular phantom model.

In DNTP, SAX is used, and additionally, when the needle tip is imaged in the screen as an echogenic point, the practitioner (a) proximally moves the US probe a bit, and then (b) the needle is advanced until the needle tip reappears in the screen. In this manner, the practitioner repeats (a) and (b) until the needle is inserted 1 cm into the lumen of vessel, and then the catheter is inserted to finish the procedure.

DNTP has not been compared to conventional imaging methods. The aim of this trial is to see the effect of DNTP on success rate of the radial artery cannulation at the first attempt, compared to the conventional LAX.

Enrollment: 146 patients

Sex: All

Ages: 19+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Elective cardiovascular surgery where RA catheterization is newly required.

Exclusion criteria

• skin infection or trauma
• Bilateral arteriovenous fistula for dialysis
• Severe peripheral vascular disease
• Severe arteriosclerosis or arterial atheroma
• Raynaud disease
• Shock
• Patients on ECMO or IABP support
• Morbid obesity
• Profound coagulopathy
• Negative results of modified Allen's test

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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146 participants in 2 patient groups

Dynamic needle tip positioning

Active Comparator group

Description:

In DNTP, SAX is used, and additionally, when the needle tip is imaged in the screen as an hyper-echoic point, the practitioner (a) moves the US probe proximally a bit, and (b) the needle is advanced until the needle tip reappears in the screen. In this manner, the practitioner repeats (a) and (b) until the needle is inserted 1 cm into the lumen of vessel, and then the catheter is inserted to finish the procedure.

Treatment:

Procedure: Dynamic needle tip positioning under ultrasound-guidance

Conventional long-axis

Active Comparator group

Treatment:

Procedure: Conventional long-axis view