US Guidance for Radial Arterial Puncture in Shock

Ismail Erkan Aydin

Status: Completed

Conditions: Shock; Shock Circulatory

Treatments: Procedure: Conventional radial artery puncture for arterial blood gas sampling; Procedure: Ultrasound-guided radial arterial puncture for arterial blood gas sampling

Study type: Interventional

Funder types: Other

Identifiers

NCT07362628

September 11, 2024 ID: 20-09

Details and patient eligibility

About

Doctors in the emergency department often need to take blood samples from an artery to understand how well a patient is breathing and how the body is responding to serious illness. This is usually done by inserting a needle into an artery at the wrist. In patients with shock, this procedure can be difficult because blood pressure is low and the pulse may be hard to feel.

In this study, two different methods for obtaining arterial blood samples were compared in adult patients presenting to the emergency department with shock. In one group, the radial artery puncture was performed with ultrasound guidance, allowing direct visualization of the artery. In the other group, the procedure was carried out using the conventional palpation technique based on manual detection of the pulse.

Patients were randomly assigned to one of the two techniques. The study assessed the success of the procedure on the first attempt, the total number of attempts required, the time needed to obtain a successful sample, and whether puncture of the femoral artery was required when radial access could not be achieved.

The aim of the study was to evaluate whether the use of ultrasound improves the efficiency and success of radial artery blood sampling in patients with shock treated in the emergency department.

Enrollment: 100 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged 18 years and older
• Patients diagnosed with shock
• Patients with an indication for arterial blood gas analysis due to respiratory or metabolic disorders
• Patients who provided written informed consent, either personally or through their legal representatives.

Exclusion criteria

• Patients who declined to participate
• Patients presenting with cardiac arrest
• Patients with a positive Allen test
• Patients with a history of coagulopathy
• Patients with evidence of infection at the puncture site
• Patients with evidence of trauma at the puncture site
• Patients with an arteriovenous fistula at the puncture site

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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100 participants in 2 patient groups

Ultrasound-Guided Radial Artery Puncture

Experimental group

Description:

Participants undergo radial artery puncture for arterial blood gas sampling using real-time ultrasound guidance.

Treatment:

Procedure: Ultrasound-guided radial arterial puncture for arterial blood gas sampling

Conventional Palpation-Guided Radial Artery Puncture

Experimental group

Description:

Participants undergo radial artery puncture for arterial blood gas sampling using the conventional palpation technique, which represents the standard practice.

Treatment:

Procedure: Conventional radial artery puncture for arterial blood gas sampling