Ultrasound-guided Versus Direct Palpation Radial Artery Catheter Insertion Among Cardiac Anesthesiologists (art-line)

University of British Columbia

Status: Completed

Conditions: Time to Insertion of Radial Artery Cannulation

Treatments: Device: Direct Palpation-guided Radial Artery Catheter insertion; Device: Ultrasound-guided Radial Artery Catheter Insertion

Study type: Interventional

Funder types: Other

Identifiers

NCT02118441

H13-00494

Details and patient eligibility

About

When a patient undergoes heart surgery, their Anesthesiologist will insert a tiny plastic tube, called a catheter, in the artery of the patient's wrist. This is called a radial artery catheter. A radial artery catheter allows accurate measurement of the patient's blood pressure during surgery. There are two common techniques for placing the radial artery catheter. The first is a "blind" technique whereby the Anesthesiologist feels for the pulse in the patient's wrist and places the catheter using the location of the pulse as a guide. The second technique, less commonly used, is one whereby the Anesthesiologist uses an ultrasound machine (painless to the patient) to "see" the artery, and thereby uses the ultrasound to guide the catheter placement. Our study will test the hypothesis that ultrasound-guided radial artery catheterization will have faster insertion times, with fewer complications compared with palpation-guided insertion.

Enrollment: 129 patients

Sex: All

Ages: 19+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients undergoing cardiac surgery
• Age 19 or older
• Provided written informed consent

Exclusion criteria

• Suspected inability to comply with study procedures, including language difficulties or medical history and/or concomitant disease, as judged by the investigator
• Previous surgery at the site of proposed radial artery catheterization
• Any vascular condition that may preclude eligibility for radial artery line insertion as judged by the investigator
• Patients with ventricular assist devices
• Previous inclusion in this study

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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129 participants in 2 patient groups

direct palpation

Active Comparator group

Description:

Radial artery catheter insertion will be conducted by direct palpation and use of anatomic knowledge by the Anesthesiologist.

Treatment:

Device: Direct Palpation-guided Radial Artery Catheter insertion

Ultrasound

Active Comparator group

Description:

Radial artery catheter insertion will be conducted by ultrasound guidance. A Sono-site ilook 25 Ultrasound (Sono-site, Inc., Bothell, WA, USA) with a 10-5 MHz linear array ultrasound transducer will be used. At the discretion on the Anesthesiologist, an out-of-plane (i.e. needle plane at right angles to ultrasound plane) will be used. Colour flow doppler may also be used to identify the artery if necessary.

Treatment:

Device: Ultrasound-guided Radial Artery Catheter Insertion