Ultrasound Assisted Arterial Cannulation in Small Children

The Hospital for Sick Children

Status

Completed

Conditions

Arterial Cannulation

Treatments

Procedure: Palpation Method

Procedure: Ultrasound

Study type

Interventional

Funder types

Other

Identifiers

NCT01742416

1000030723

Details and patient eligibility

About

Arterial cannulation is a commonly performed invasive procedure in the operation room, the emergency department, and in the intensive care unit. The indications include the need for continuous blood-pressure monitoring, frequent arterial blood-gas analysis, and repeated blood sampling for laboratory evaluation. This procedure can be challenging even in the best of hands. Traditionally, the artery is located by feeling the pulse of the patient. The pulse may, however be weak or absent in patients with hypotension, edema, obesity or local thrombosis due to previous arterial cannulation in the same location. Furthermore, the catheter may not be passed successfully into the artery, despite apparent good blood return on initial puncture, or hematoma and spasms of the artery may develop after failed attempts, thus making further attempts even more difficult. While ultrasound (US) is being used with increasing frequency for central venous access, fewer clinicians are familiar with US-guided arterial catheterization. The aim of this study is to investigate if ultrasound facilitates arterial cannulation in children ≤24 months compared with the palpation method and to investigate the potential extra costs/savings of introducing the method. This study hypothesizes that the ultrasound method will facilitate arterial cannulation in small children compared with the palpation method.

Enrollment

40 patients

Sex

All

Ages

1 day to 24 months old

Volunteers

No Healthy Volunteers

Inclusion criteria

Children 24 months or younger
Children undergoing elective surgical procedures where arterial cannulation is planned by the attending anaesthetist. These procedures include cardiac surgery, craniotomies, cranial vault surgery, and some abdominal procedures.

Exclusion criteria

Refusal of consent from the parents
Refusal of participation from the anaesthetist
Children with anticipated circulatory instability after anaesthesia induction
1. Pulmonary hypertension defined as an estimated pulmonary arterial pressure which is greater than or equal to 66% of systemic blood pressure
2. Children with severe heart failure (right and/or left)